JOANNE M MANGUN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012052

License Status

NOT RENEWED

Business

First Name

JOANNE

Middle

Last Name

MANGUN

Business Name

JOANNE M MANGUN

Original Issue Date

08/22/2000

Effective Date

07/14/2014

Expiration Date

09/30/2016

City

MERIDIAN

State

Zip

83646

County

IDAHO

Ever Disciplined

LastModifiedDate

11/26/2016