ETHAN MYLES WHITAKER - Physical Therapist License in Wisconsin | # 160008531

ETHAN MYLES WHITAKER

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160008531

License Status

NOT RENEWED

Business

N

First Name

ETHAN

Middle

MYLES

Last Name

WHITAKER

Business Name

ETHAN MYLES WHITAKER

Original Issue Date

03/26/2019

Effective Date

09/30/2019

Expiration Date

01/31/2022

State

WI

Ever Disciplined

N

LastModifiedDate

05/19/2022