ILENE L LARSON - Physical Therapist License in Wisconsin | # 070001694

ILENE L LARSON

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070001694

License Status

NOT RENEWED

Business

N

First Name

ILENE L

Last Name

LARSON

Business Name

ILENE L LARSON

Original Issue Date

05/23/1973

Effective Date

10/01/2006

Expiration Date

09/30/2008

State

WI

Ever Disciplined

N

LastModifiedDate

11/06/2008