SUSAN E LANE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160001600

License Status

NOT RENEWED

Business

First Name

SUSAN E

Last Name

LANE

Business Name

SUSAN E LANE

Original Issue Date

11/06/1992

Effective Date

11/06/1992

Expiration Date

09/30/1995

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/14/2005