TARA N LONG Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070017775

License Status

NOT RENEWED

Business

First Name

TARA

Middle

Last Name

LONG

Business Name

TARA N LONG

Original Issue Date

05/13/2010

Effective Date

08/06/2012

Expiration Date

09/30/2014

City

COLUMBUS

State

Zip

31909

County

GEORGIA

Ever Disciplined

LastModifiedDate

11/17/2014