JENNIFER L WALLACE Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070009079

License Status

INACTIVE

Business

First Name

JENNIFER

Middle

Last Name

WALLACE

Business Name

JENNIFER L WALLACE

Original Issue Date

09/16/1995

Effective Date

09/03/2014

Expiration Date

09/30/2016

City

SAINT PETERSBURG

State

Zip

33711

County

FLORIDA

Ever Disciplined

LastModifiedDate

07/06/2016