DIANE L MICKLE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070004376

License Status

NOT RENEWED

Business

First Name

DIANE L

Last Name

MICKLE

Business Name

DIANE L MICKLE

Original Issue Date

01/14/1985

Effective Date

01/14/1985

Expiration Date

09/30/1986

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

10/14/2005