GILLIAN H DEN HAESE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070008816

License Status

NOT RENEWED

Business

First Name

GILLIAN H

Last Name

DEN HAESE

Business Name

GILLIAN H DEN HAESE

Original Issue Date

05/15/1995

Effective Date

05/15/1995

Expiration Date

09/30/2000

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

10/17/2005