KELLY C FAGUNDES - Physical Therapist License in Wisconsin | # 070013927

KELLY C FAGUNDES

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013927

License Status

INACTIVE

Business

N

First Name

KELLY

Middle

C

Last Name

FAGUNDES

Business Name

KELLY C FAGUNDES

Original Issue Date

05/24/2004

Effective Date

07/10/2008

Expiration Date

09/30/2010

State

WI

Ever Disciplined

N

LastModifiedDate

07/08/2010