JACKIE NICHOLS CHAMBERLAIN - Physical Therapist License in Illinois | # 070004903

JACKIE NICHOLS CHAMBERLAIN

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070004903

License Status

INACTIVE

Business

N

First Name

JACKIE NICHOLS

Last Name

CHAMBERLAIN

Business Name

JACKIE NICHOLS CHAMBERLAIN

Original Issue Date

12/22/1986

Effective Date

09/30/2004

Expiration Date

09/30/2006

State

IL

Ever Disciplined

N

LastModifiedDate

07/13/2006