KIM GEPANA TAN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070019410

License Status

NOT RENEWED

Business

First Name

KIM

Middle

GEPANA

Last Name

TAN

Business Name

KIM GEPANA TAN

Original Issue Date

08/20/2012

Effective Date

08/20/2014

Expiration Date

09/30/2016

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

11/26/2016