BONNIE S BREITBARTH Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070004364

License Status

NOT RENEWED

Business

First Name

BONNIE S

Last Name

BREITBARTH

Business Name

BONNIE S BREITBARTH

Original Issue Date

01/14/1985

Effective Date

09/19/2018

Expiration Date

09/30/2020

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

01/14/2021