DONNA JO BLAKE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002205

License Status

NOT RENEWED

Business

First Name

DONNA JO

Last Name

BLAKE

Business Name

DONNA JO BLAKE

Original Issue Date

06/08/1976

Effective Date

06/08/1976

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

10/14/2005