JENELLE M DEATHERAGE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070020706

License Status

NOT RENEWED

Business

First Name

JENELLE

Middle

Last Name

DEATHERAGE

Business Name

JENELLE M DEATHERAGE

Original Issue Date

06/24/2014

Effective Date

08/06/2018

Expiration Date

09/30/2020

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

01/14/2021