JILLENE M BLOMBERG - Physical Therapist License in Illinois | # 160002710

JILLENE M BLOMBERG

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002710

License Status

NOT RENEWED

Business

N

First Name

JILLENE M

Last Name

BLOMBERG

Business Name

JILLENE M BLOMBERG

Original Issue Date

04/21/1997

Effective Date

08/17/2017

Expiration Date

09/30/2019

State

IL

Ever Disciplined

N

LastModifiedDate

01/13/2020