NICHOLAS J LONG Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070017264

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

Last Name

LONG

Business Name

NICHOLAS J LONG

Original Issue Date

07/28/2009

Effective Date

09/30/2010

Expiration Date

09/30/2012

City

ATLANTA

State

Zip

30342

County

GEORGIA

Ever Disciplined

LastModifiedDate

01/16/2013