WIM DEN HAESE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070008531

License Status

NOT RENEWED

Business

First Name

WIM

Last Name

DEN HAESE

Business Name

WIM DEN HAESE

Original Issue Date

01/17/1995

Effective Date

01/17/1995

Expiration Date

09/30/2000

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

10/17/2005