LACEY E K COLLARD Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006363

License Status

NOT RENEWED

Business

First Name

LACEY

Middle

E K

Last Name

COLLARD

Business Name

LACEY E K COLLARD

Original Issue Date

05/06/2013

Effective Date

08/14/2015

Expiration Date

09/30/2017

City

AUGUSTA

State

Zip

30904

Ever Disciplined

LastModifiedDate

11/01/2017