NICHOLE SHANNON BLIESNER - Physical Therapist License in Wisconsin | # 160004926

NICHOLE SHANNON BLIESNER

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004926

License Status

NOT RENEWED

Business

N

First Name

NICHOLE

Middle

SHANNON

Last Name

BLIESNER

Business Name

NICHOLE SHANNON BLIESNER

Original Issue Date

11/30/2007

Effective Date

11/30/2007

Expiration Date

09/30/2009

State

WI

Ever Disciplined

N

LastModifiedDate

11/04/2009