BENJAMIN P KERVIN Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013046

License Status

INACTIVE

Business

First Name

BENJAMIN

Middle

Last Name

KERVIN

Business Name

BENJAMIN P KERVIN

Original Issue Date

05/10/2002

Effective Date

07/08/2016

Expiration Date

09/30/2018

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/07/2018