SALLY J LANGE - Physical Therapist License in Wisconsin | # 160002763

SALLY J LANGE

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002763

License Status

NOT RENEWED

Business

N

First Name

SALLY J

Last Name

LANGE

Business Name

SALLY J LANGE

Original Issue Date

08/27/1997

Effective Date

08/27/1997

Expiration Date

09/30/2003

State

WI

Ever Disciplined

N

LastModifiedDate

10/17/2005