KEITH E SHAW Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070006534

License Status

NOT RENEWED

Business

First Name

KEITH E

Last Name

SHAW

Business Name

KEITH E SHAW

Original Issue Date

09/19/1991

Effective Date

07/28/2008

Expiration Date

09/30/2010

City

CENTRALIA

State

Zip

62801

County

MARION

Ever Disciplined

LastModifiedDate

11/08/2010