DONNA CAMPBELL FORTUNE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070001617

License Status

NOT RENEWED

Business

First Name

DONNA CAMPBELL

Last Name

FORTUNE

Business Name

DONNA CAMPBELL FORTUNE

Original Issue Date

12/22/1972

Effective Date

12/22/1972

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/14/2005