MARTHA C DERLETH - Physical Therapist License in Illinois | # 070001819

MARTHA C DERLETH

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070001819

License Status

INACTIVE

Business

N

First Name

MARTHA C

Last Name

DERLETH

Business Name

MARTHA C DERLETH

Original Issue Date

05/06/1974

Effective Date

05/06/1974

Expiration Date

09/30/2002

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005