EDWIN R ITALIA - Physical Therapist License in Illinois | # 070013971

EDWIN R ITALIA

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013971

License Status

INACTIVE

Business

N

First Name

EDWIN

Middle

R

Last Name

ITALIA

Business Name

EDWIN R ITALIA

Original Issue Date

06/15/2004

Effective Date

10/01/2012

Expiration Date

09/30/2014

State

IL

Ever Disciplined

N

LastModifiedDate

07/03/2014