KATHERINE SULLIV BLACK - Physical Therapist License in Illinois | # 070002706

KATHERINE SULLIV BLACK

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002706

License Status

NOT RENEWED

Business

N

First Name

KATHERINE SULLIV

Last Name

BLACK

Business Name

KATHERINE SULLIV BLACK

Original Issue Date

11/27/1978

Effective Date

11/27/1978

Expiration Date

09/30/1988

State

IL

Ever Disciplined

N

LastModifiedDate

10/14/2005