PREMILA MARTIN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070014746

License Status

NOT RENEWED

Business

First Name

PREMILA

Last Name

MARTIN

Business Name

PREMILA MARTIN

Original Issue Date

05/20/2004

Effective Date

08/27/2018

Expiration Date

09/30/2020

City

PLAINFIELD

State

Zip

60585

County

WILL

Ever Disciplined

LastModifiedDate

01/14/2021