RANDY SCOTT WIECK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070003127

License Status

NOT RENEWED

Business

First Name

RANDY SCOTT

Last Name

WIECK

Business Name

RANDY SCOTT WIECK

Original Issue Date

12/24/1979

Effective Date

12/24/1979

Expiration Date

09/30/1984

City

MENDOTA

State

Zip

61342

County

LA SALLE

Ever Disciplined

LastModifiedDate

10/14/2005