RICHARD W KRUCKEBERG Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002766

License Status

ACTIVE

Business

First Name

RICHARD W

Last Name

KRUCKEBERG

Business Name

RICHARD W KRUCKEBERG

Original Issue Date

12/18/1978

Effective Date

09/03/2024

Expiration Date

09/30/2026

City

SULLIVAN

State

Zip

61951

County

MOULTRIE

Ever Disciplined

LastModifiedDate

09/03/2024