MARK FREDRICK GOODRICH - Physical Therapist License in Indiana | # 070007864

MARK FREDRICK GOODRICH

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070007864

License Status

INACTIVE

Business

N

First Name

MARK

Middle

FREDRICK

Last Name

GOODRICH

Business Name

MARK FREDRICK GOODRICH

Original Issue Date

10/20/1993

Effective Date

10/20/1993

Expiration Date

09/30/1998

State

IN

Ever Disciplined

N

LastModifiedDate

10/14/2005