DIANE MARIE CARLSON - Physical Therapist License in Illinois | # 070002074

DIANE MARIE CARLSON

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002074

License Status

NOT RENEWED

Business

N

First Name

DIANE MARIE

Last Name

CARLSON

Business Name

DIANE MARIE CARLSON

Original Issue Date

01/16/1976

Effective Date

01/16/1976

Expiration Date

09/30/1984

State

IL

Ever Disciplined

N

LastModifiedDate

10/14/2005