JACOB J BLIEFERNICHT Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070015662

License Status

NOT RENEWED

Business

First Name

JACOB

Middle

Last Name

BLIEFERNICHT

Business Name

JACOB J BLIEFERNICHT

BusinessDBA

BLIEFERNICHT

Original Issue Date

03/23/2007

Effective Date

08/28/2008

Expiration Date

09/30/2010

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

11/08/2010