SUSAN M GOODMAN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160000993

License Status

NOT RENEWED

Business

First Name

SUSAN M

Last Name

GOODMAN

Business Name

SUSAN M GOODMAN

Original Issue Date

11/20/1991

Effective Date

08/25/2017

Expiration Date

09/30/2019

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

01/13/2020