KRISTI LYNN WALLACE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160000274

License Status

NOT RENEWED

Business

First Name

KRISTI LYNN

Last Name

WALLACE

Business Name

KRISTI LYNN WALLACE

Original Issue Date

07/22/1991

Effective Date

09/30/2019

Expiration Date

01/31/2022

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

05/19/2022