ANTHONY D HAGAMAN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160001020

License Status

NOT RENEWED

Business

First Name

ANTHONY D

Last Name

HAGAMAN

Business Name

ANTHONY D HAGAMAN

Original Issue Date

11/23/1991

Effective Date

11/23/1991

Expiration Date

09/30/2005

City

MAPLETON

State

Zip

61547

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005