JACOB S JACKSON Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070024163

License Status

NOT RENEWED

Business

First Name

JACOB

Middle

Last Name

JACKSON

Business Name

JACOB S JACKSON

Original Issue Date

02/14/2019

Effective Date

02/14/2019

Expiration Date

09/30/2020

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

01/14/2021