KELLY ANN RENEE TALTY - Physical Therapist License in Wisconsin | # 160005398

KELLY ANN RENEE TALTY

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160005398

License Status

NOT RENEWED

Business

N

First Name

KELLY ANN

Middle

RENEE

Last Name

TALTY

Business Name

KELLY ANN RENEE TALTY

Original Issue Date

01/27/2010

Effective Date

09/30/2015

Expiration Date

09/30/2017

State

WI

Ever Disciplined

N

LastModifiedDate

11/01/2017