TIFFANY MARIE PETERSEN - Physical Therapist License in Illinois | # 160004462

TIFFANY MARIE PETERSEN

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004462

License Status

NOT RENEWED

Business

N

First Name

TIFFANY

Middle

MARIE

Last Name

PETERSEN

Business Name

TIFFANY MARIE PETERSEN

Original Issue Date

09/06/2005

Effective Date

10/13/2020

Expiration Date

01/31/2022

State

IL

Ever Disciplined

N

LastModifiedDate

05/19/2022