SHANNON D BLANK Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070010392

License Status

ACTIVE

Business

First Name

SHANNON D

Last Name

BLANK

Business Name

SHANNON D BLANK

Original Issue Date

12/18/1997

Effective Date

07/04/2024

Expiration Date

09/30/2026

City

OLNEY

State

Zip

62450

County

RICHLAND

Ever Disciplined

LastModifiedDate

07/04/2024