JEAN M CLARK Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002452

License Status

INACTIVE

Business

First Name

JEAN M

Last Name

CLARK

Business Name

JEAN M CLARK

Original Issue Date

12/30/1977

Effective Date

12/30/1977

Expiration Date

09/30/2000

City

FORT COLLINS

State

Zip

80525

County

COLORADO

Ever Disciplined

LastModifiedDate

10/17/2005