VICKI J BLACK Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002947

License Status

INACTIVE

Business

First Name

VICKI J

Last Name

BLACK

Business Name

VICKI J BLACK

Original Issue Date

06/28/1979

Effective Date

06/28/1979

Expiration Date

09/30/1998

City

OLNEY

State

Zip

62450

County

RICHLAND

Ever Disciplined

LastModifiedDate

10/14/2005