KATHERINE SULLIV BLACK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002706

License Status

NOT RENEWED

Business

First Name

KATHERINE SULLIV

Last Name

BLACK

Business Name

KATHERINE SULLIV BLACK

Original Issue Date

11/27/1978

Effective Date

11/27/1978

Expiration Date

09/30/1988

City

GLENVIEW

State

Zip

60025

County

COOK

Ever Disciplined

LastModifiedDate

10/14/2005