JOANNE M MANGUN - Physical Therapist License in Idaho | # 070012052

JOANNE M MANGUN

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012052

License Status

NOT RENEWED

Business

N

First Name

JOANNE

Middle

M

Last Name

MANGUN

Business Name

JOANNE M MANGUN

Original Issue Date

08/22/2000

Effective Date

07/14/2014

Expiration Date

09/30/2016

State

ID

Ever Disciplined

N

LastModifiedDate

11/26/2016