JEFFREY S FLACK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160000592

License Status

NOT RENEWED

Business

First Name

JEFFREY S

Last Name

FLACK

Business Name

JEFFREY S FLACK

Original Issue Date

09/26/1991

Effective Date

08/22/2019

Expiration Date

01/31/2022

City

PETERSBURG

State

Zip

62675

County

MENARD

Ever Disciplined

LastModifiedDate

05/19/2022