BRENT D BETZOLD - Physical Therapist License in Illinois | # 070012076

BRENT D BETZOLD

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012076

License Status

NOT RENEWED

Business

N

First Name

BRENT

Middle

D

Last Name

BETZOLD

Business Name

BRENT D BETZOLD

Original Issue Date

08/29/2000

Effective Date

08/29/2000

Expiration Date

09/30/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005