LESLIE SMITH SAND Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002339

License Status

NOT RENEWED

Business

First Name

LESLIE SMITH

Last Name

SAND

Business Name

LESLIE SMITH SAND

Original Issue Date

01/11/1977

Effective Date

01/11/1977

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/14/2005