CECILIA M WALLER Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070009061

License Status

NOT RENEWED

Business

First Name

CECILIA M

Last Name

WALLER

Business Name

CECILIA M WALLER

Original Issue Date

09/11/1995

Effective Date

09/11/1995

Expiration Date

09/30/1996

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/14/2005