JACKSON D DAVENPORT Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070026760

License Status

NOT RENEWED

Business

First Name

JACKSON

Middle

Last Name

DAVENPORT

Business Name

JACKSON D DAVENPORT

Original Issue Date

07/08/2022

Effective Date

07/08/2022

Expiration Date

09/30/2024

City

GURNEE

State

Zip

60031

Ever Disciplined

LastModifiedDate

02/27/2025