GEORGIA R SIRTAK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160000390

License Status

NOT RENEWED

Business

First Name

GEORGIA R

Last Name

SIRTAK

Business Name

GEORGIA R SIRTAK

Original Issue Date

08/05/1991

Effective Date

08/05/1991

Expiration Date

09/30/1997

City

PRAIRIE DUROCHER

State

Zip

62277

County

RANDOLPH

Ever Disciplined

LastModifiedDate

10/14/2005