MARTIENE HICKAM Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011347

License Status

NOT RENEWED

Business

First Name

MARTIENE

Last Name

HICKAM

Business Name

MARTIENE HICKAM

Original Issue Date

06/01/1999

Effective Date

06/01/1999

Expiration Date

09/30/2002

City

LINCOLN

State

Zip

62656

County

LOGAN

Ever Disciplined

LastModifiedDate

10/17/2005