MAIDEN LOUISE AXALAN BACOLOD Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070016218

License Status

NOT RENEWED

Business

First Name

MAIDEN LOUISE

Middle

AXALAN

Last Name

BACOLOD

Business Name

MAIDEN LOUISE AXALAN BACOLOD

Original Issue Date

02/20/2008

Effective Date

09/25/2014

Expiration Date

09/30/2016

City

TAYLORVILLE

State

Zip

62568

County

CHRISTIAN

Ever Disciplined

LastModifiedDate

11/26/2016