STACEY L GROHMANN Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004104

License Status

INACTIVE

Business

First Name

STACEY

Middle

Last Name

GROHMANN

Business Name

STACEY L GROHMANN

Original Issue Date

10/09/2002

Effective Date

10/09/2002

Expiration Date

09/30/2003

City

JACKSONVILLE

State

Zip

32256

County

FLORIDA

Ever Disciplined

LastModifiedDate

10/17/2005