JUSTIN RYAN SHEPHERD Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070014481

License Status

NOT RENEWED

Business

First Name

JUSTIN

Middle

RYAN

Last Name

SHEPHERD

Business Name

JUSTIN RYAN SHEPHERD

Original Issue Date

06/27/2005

Effective Date

06/27/2005

Expiration Date

09/30/2006

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

11/08/2006