DORIS JEAN DAVENPORT Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002014

License Status

INACTIVE

Business

First Name

DORIS JEAN

Last Name

DAVENPORT

Business Name

DORIS JEAN DAVENPORT

Original Issue Date

06/11/1975

Effective Date

07/16/2010

Expiration Date

09/30/2012

City

BLOOMINGTON

State

Zip

61705

County

MCLEAN

Ever Disciplined

LastModifiedDate

07/05/2012