LISA M KROG Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004700

License Status

INACTIVE

Business

First Name

LISA

Middle

Last Name

KROG

Business Name

LISA M KROG

BusinessDBA

ATHMANN

Original Issue Date

11/14/2006

Effective Date

08/17/2015

Expiration Date

09/30/2017

City

GROVETOWN

State

Zip

30813

Ever Disciplined

LastModifiedDate

07/07/2017