ANDREW WAYNE JELLEMA - Physical Therapist License in Indiana | # 070020408

ANDREW WAYNE JELLEMA

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070020408

License Status

NOT RENEWED

Business

N

First Name

ANDREW

Middle

WAYNE

Last Name

JELLEMA

Business Name

ANDREW WAYNE JELLEMA

Original Issue Date

11/14/2013

Effective Date

09/02/2014

Expiration Date

09/30/2016

State

IN

Ever Disciplined

N

LastModifiedDate

11/26/2016