NICHOLAS J LONG - Physical Therapist License in Georgia | # 070017264

NICHOLAS J LONG

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070017264

License Status

NOT RENEWED

Business

N

First Name

NICHOLAS

Middle

J

Last Name

LONG

Business Name

NICHOLAS J LONG

Original Issue Date

07/28/2009

Effective Date

09/30/2010

Expiration Date

09/30/2012

State

GA

Ever Disciplined

N

LastModifiedDate

01/16/2013