MICHELLE L BALLAN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012035

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

Last Name

BALLAN

Business Name

MICHELLE L BALLAN

Original Issue Date

08/10/2000

Effective Date

08/10/2000

Expiration Date

09/30/2002

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005