PAM J JACKSON Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070004547

License Status

INACTIVE

Business

First Name

PAM J

Last Name

JACKSON

Business Name

PAM J JACKSON

Original Issue Date

08/16/1985

Effective Date

08/16/1985

Expiration Date

09/30/1988

City

LOAMI

State

Zip

62661

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/14/2005