MONA R BLAINE - Physical Therapist License in Missouri | # 160002855

MONA R BLAINE

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002855

License Status

INACTIVE

Business

N

First Name

MONA R

Last Name

BLAINE

Business Name

MONA R BLAINE

Original Issue Date

10/23/1997

Effective Date

09/30/2005

Expiration Date

09/30/2007

State

MO

Ever Disciplined

N

LastModifiedDate

07/05/2007