SUSAN MARIE FONKEN - Physical Therapist License in Illinois | # 070018350

SUSAN MARIE FONKEN

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070018350

License Status

NOT RENEWED

Business

N

First Name

SUSAN

Middle

MARIE

Last Name

FONKEN

Business Name

SUSAN MARIE FONKEN

Original Issue Date

03/16/2011

Effective Date

07/30/2012

Expiration Date

09/30/2014

State

IL

Ever Disciplined

N

LastModifiedDate

11/17/2014