SUPA PONGLORPISIT Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070004357

License Status

INACTIVE

Business

First Name

SUPA

Last Name

PONGLORPISIT

Business Name

SUPA PONGLORPISIT

Original Issue Date

12/28/1984

Effective Date

10/01/2006

Expiration Date

09/30/2008

City

GLENVIEW

State

Zip

60026

County

COOK

Ever Disciplined

LastModifiedDate

07/10/2008