ROSE R KOSTYSHOCK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160000348

License Status

NOT RENEWED

Business

First Name

ROSE R

Last Name

KOSTYSHOCK

Business Name

ROSE R KOSTYSHOCK

Original Issue Date

08/06/1991

Effective Date

08/06/1991

Expiration Date

09/30/2005

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

10/17/2005