DEREK T JOHNSON Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070010818

License Status

NOT RENEWED

Business

First Name

DEREK

Middle

Last Name

JOHNSON

Business Name

DEREK T JOHNSON

Original Issue Date

09/18/1998

Effective Date

09/18/1998

Expiration Date

09/30/2004

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005