BRAD ADAM MOLTRUP Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013301

License Status

INACTIVE

Business

First Name

BRAD

Middle

ADAM

Last Name

MOLTRUP

Business Name

BRAD ADAM MOLTRUP

Original Issue Date

11/18/2002

Effective Date

10/01/2018

Expiration Date

09/30/2020

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

07/27/2020