ELIZABETH A CLARK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070005058

License Status

NOT RENEWED

Business

First Name

ELIZABETH A

Last Name

CLARK

Business Name

ELIZABETH A CLARK

Original Issue Date

03/28/1987

Effective Date

03/28/1987

Expiration Date

09/30/1990

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/14/2005