JILLIAN ANN STAPLEMAN - Physical Therapist License in Wisconsin | # 160004318

JILLIAN ANN STAPLEMAN

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004318

License Status

NOT RENEWED

Business

N

First Name

JILLIAN

Middle

ANN

Last Name

STAPLEMAN

Business Name

JILLIAN ANN STAPLEMAN

Original Issue Date

08/23/2004

Effective Date

07/05/2007

Expiration Date

09/30/2009

State

WI

Ever Disciplined

N

LastModifiedDate

11/04/2009