WALLACE A SWAN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002637

License Status

NOT RENEWED

Business

First Name

WALLACE A

Last Name

SWAN

Business Name

WALLACE A SWAN

Original Issue Date

05/01/1978

Effective Date

05/01/1978

Expiration Date

09/30/2004

City

AURORA

State

Zip

60506

County

KANE

Ever Disciplined

LastModifiedDate

10/17/2005