GREGORY M BLAKELY Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070005246

License Status

NOT RENEWED

Business

First Name

GREGORY M

Last Name

BLAKELY

Business Name

GREGORY M BLAKELY

Original Issue Date

12/12/1987

Effective Date

09/09/2022

Expiration Date

09/30/2024

City

ANNA

State

Zip

62906

County

UNION

Ever Disciplined

LastModifiedDate

02/27/2025