General Information


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General Information
  • Name:Stacey Nicole Bollin, OT-A
  • Primary Specialty:
Address Information
  • Mailing Address: 8914 South 30th Street
  • Address 2:
  • City:Fort Smith
  • State: AR
  • Zip:72908
  • Phone:(479) 650-5030
  • Fax:
License Information
  • License Number: OT-A1199
  • Original Issue Date: 02/17/2017
  • Expiration Date:06/30/2018
  • Basis: Exam
  • License Status: Active
  • License Category: Unlimited
  • License Number: OT2016-047
  • Original Issue Date: 12/30/2016
  • Expiration Date:03/28/2017
  • Basis: Exam
  • License Status: Inactive
  • License Category: Temporary
Board History
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