NATHAN DAVID JACK KENISTON - Physical Therapist License in Illinois | # 070022218

NATHAN DAVID JACK KENISTON

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070022218

License Status

NOT RENEWED

Business

N

First Name

NATHAN

Middle

DAVID JACK

Last Name

KENISTON

Business Name

NATHAN DAVID JACK KENISTON

Original Issue Date

07/06/2016

Effective Date

07/30/2018

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

01/14/2021