MARK H HAGEN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070005127

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

HAGEN

Business Name

MARK H HAGEN

Original Issue Date

04/11/1987

Effective Date

09/08/2008

Expiration Date

09/30/2010

City

ELSAH

State

Zip

62028

County

JERSEY

Ever Disciplined

LastModifiedDate

11/08/2010