GWENDOLYN JANE FAVERO Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070001748

License Status

NOT RENEWED

Business

First Name

GWENDOLYN JANE

Last Name

FAVERO

Business Name

GWENDOLYN JANE FAVERO

Original Issue Date

11/13/1973

Effective Date

11/13/1973

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/14/2005