BLAINE ERICKSON HAWKES - Physical Therapist License in Idaho | # 070021463

BLAINE ERICKSON HAWKES

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070021463

License Status

NOT RENEWED

Business

N

First Name

BLAINE

Middle

ERICKSON

Last Name

HAWKES

Business Name

BLAINE ERICKSON HAWKES

Original Issue Date

08/05/2015

Effective Date

10/02/2018

Expiration Date

09/30/2020

State

ID

Ever Disciplined

N

LastModifiedDate

01/14/2021