DIANE L POLK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160000618

License Status

NOT RENEWED

Business

First Name

DIANE L

Last Name

POLK

Business Name

DIANE L POLK

Original Issue Date

09/30/1991

Effective Date

09/30/2005

Expiration Date

09/30/2007

City

MORTON

State

Zip

61550

County

TAZEWELL

Ever Disciplined

LastModifiedDate

03/25/2008