TATUM NICHOLS DPT Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070025835

License Status

ACTIVE

Business

Title

DPT

First Name

TATUM

Last Name

NICHOLS

Business Name

TATUM NICHOLS DPT

Original Issue Date

04/28/2021

Effective Date

09/20/2024

Expiration Date

09/30/2026

City

METAMORA

State

Zip

61548

County

WOODFORD

Ever Disciplined

LastModifiedDate

09/20/2024