JASON MICHAEL DEBOOM Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004342

License Status

INACTIVE

Business

First Name

JASON

Middle

MICHAEL

Last Name

DEBOOM

Business Name

JASON MICHAEL DEBOOM

Original Issue Date

09/14/2004

Effective Date

09/30/2005

Expiration Date

09/30/2007

City

ALTOONA

State

Zip

50009

County

IOWA

Ever Disciplined

LastModifiedDate

07/05/2007