| Type | 5 Year Limited |
|---|---|
| Issue Date | 1/23/1996 |
| Expire Date | 7/1/2001 |
| Baccalaureate of Science - Northern State University (MAJOR: Communication Disorders) |
| Baccalaureate of Science - Northern State University (MAJOR: Special Education) |
| 402 - Birth-21 School Speech/Language Pathologist |