K SLADE DIETZ - Physical Therapist License in Illinois | # 160002737

K SLADE DIETZ

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002737

License Status

NOT RENEWED

Business

N

First Name

K

Middle

SLADE

Last Name

DIETZ

Business Name

K SLADE DIETZ

Original Issue Date

07/31/1997

Effective Date

07/09/2009

Expiration Date

09/30/2011

State

IL

Ever Disciplined

N

LastModifiedDate

11/04/2011