SHANE W IRGENS Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070018218

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

IRGENS

Business Name

SHANE W IRGENS

Original Issue Date

11/22/2010

Effective Date

11/22/2010

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

01/16/2013