MARTINE DEROM - Physical Therapist License in Illinois | # 070008753

MARTINE DEROM

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070008753

License Status

NOT RENEWED

Business

N

First Name

MARTINE

Last Name

DEROM

Business Name

MARTINE DEROM

Original Issue Date

05/04/1995

Effective Date

09/15/2020

Expiration Date

09/30/2022

State

IL

Ever Disciplined

N

LastModifiedDate

11/28/2022