DANIELLE R BULTEMA - Physical Therapist License in Indiana | # 160004602

DANIELLE R BULTEMA

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004602

License Status

NOT RENEWED

Business

N

First Name

DANIELLE

Middle

R

Last Name

BULTEMA

Business Name

DANIELLE R BULTEMA

Original Issue Date

07/27/2006

Effective Date

09/30/2015

Expiration Date

09/30/2017

State

IN

Ever Disciplined

N

LastModifiedDate

11/01/2017