DIANNE ELLEN HERGENROTHER Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012499

License Status

ACTIVE

Business

First Name

DIANNE

Middle

ELLEN

Last Name

HERGENROTHER

Business Name

DIANNE ELLEN HERGENROTHER

Original Issue Date

06/06/2001

Effective Date

09/03/2024

Expiration Date

09/30/2026

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/03/2024