ROGER W LONG Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070001904

License Status

NOT RENEWED

Business

First Name

ROGER W

Last Name

LONG

Business Name

ROGER W LONG

Original Issue Date

11/15/1974

Effective Date

11/15/1974

City

DAVENPORT

State

Zip

52804

County

IOWA

Ever Disciplined

LastModifiedDate

10/14/2005