JISSA J CHAKKUMCAL - Physical Therapist License in Illinois | # 070013831

JISSA J CHAKKUMCAL

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013831

License Status

INACTIVE

Business

N

First Name

JISSA

Middle

J

Last Name

CHAKKUMCAL

Business Name

JISSA J CHAKKUMCAL

Original Issue Date

03/15/2004

Effective Date

09/30/2004

Expiration Date

09/30/2006

State

IL

Ever Disciplined

N

LastModifiedDate

07/13/2006