DIANE S KOCH Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002889

License Status

NOT RENEWED

Business

First Name

DIANE S

Last Name

KOCH

Business Name

DIANE S KOCH

Original Issue Date

04/20/1979

Effective Date

04/20/1979

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

10/14/2005