JISSA J CHAKKUMCAL Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013831

License Status

INACTIVE

Business

First Name

JISSA

Middle

Last Name

CHAKKUMCAL

Business Name

JISSA J CHAKKUMCAL

Original Issue Date

03/15/2004

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

ELMHURST

State

Zip

60126

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/13/2006