EDWIN R ITALIA Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013971

License Status

INACTIVE

Business

First Name

EDWIN

Middle

Last Name

ITALIA

Business Name

EDWIN R ITALIA

Original Issue Date

06/15/2004

Effective Date

10/01/2012

Expiration Date

09/30/2014

City

ARLINGTON HEIGHTS

State

Zip

60004

County

COOK

Ever Disciplined

LastModifiedDate

07/03/2014