MICHAEL R GRISSOM Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070004539

License Status

NOT RENEWED

Business

First Name

MICHAEL R

Last Name

GRISSOM

Business Name

MICHAEL R GRISSOM

Original Issue Date

08/16/1985

Effective Date

08/16/1985

Expiration Date

09/30/1986

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/14/2005