DIANE MARIE CARLSON Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002074

License Status

NOT RENEWED

Business

First Name

DIANE MARIE

Last Name

CARLSON

Business Name

DIANE MARIE CARLSON

Original Issue Date

01/16/1976

Effective Date

01/16/1976

Expiration Date

09/30/1984

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/14/2005