IVORY TEODORO FOX - Physical Therapist License in Indiana | # 070011350

IVORY TEODORO FOX

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011350

License Status

NOT RENEWED

Business

N

First Name

IVORY

Middle

TEODORO

Last Name

FOX

Business Name

IVORY TEODORO FOX

Original Issue Date

06/01/1999

Effective Date

06/01/1999

Expiration Date

09/30/2002

State

IN

Ever Disciplined

N

LastModifiedDate

10/17/2005