DOUGLAS A WIERENGA - Physical Therapist License in Illinois | # 160006179

DOUGLAS A WIERENGA

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006179

License Status

NOT RENEWED

Business

N

First Name

DOUGLAS

Middle

A

Last Name

WIERENGA

Business Name

DOUGLAS A WIERENGA

Original Issue Date

09/04/2012

Effective Date

09/16/2013

Expiration Date

09/30/2015

State

IL

Ever Disciplined

N

LastModifiedDate

11/03/2015