RIC DOUGLAS STARK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012877

License Status

NOT RENEWED

Business

First Name

RIC

Middle

DOUGLAS

Last Name

STARK

Business Name

RIC DOUGLAS STARK

Original Issue Date

03/04/2002

Effective Date

03/04/2002

Expiration Date

09/30/2002

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

10/17/2005