KEVIN J KIETZMAN Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013788

License Status

ACTIVE

Business

First Name

KEVIN

Middle

Last Name

KIETZMAN

Business Name

KEVIN J KIETZMAN

Original Issue Date

02/09/2004

Effective Date

07/17/2024

Expiration Date

09/30/2026

City

TAYLORVILLE

State

Zip

62568

County

CHRISTIAN

Ever Disciplined

LastModifiedDate

07/17/2024