KIM E FONNER - Physical Therapist License in Illinois | # 160002514

KIM E FONNER

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002514

License Status

NOT RENEWED

Business

N

First Name

KIM E

Last Name

FONNER

Business Name

KIM E FONNER

Original Issue Date

10/19/1996

Effective Date

10/02/2017

Expiration Date

09/30/2019

State

IL

Ever Disciplined

N

LastModifiedDate

01/13/2020