BRANDON W DIVAN Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070024617

License Status

ACTIVE

Business

First Name

BRANDON

Middle

Last Name

DIVAN

Business Name

BRANDON W DIVAN

Original Issue Date

08/19/2019

Effective Date

07/10/2024

Expiration Date

09/30/2026

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

07/10/2024