SHOSHANA B CHURCH Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160001653

License Status

NOT RENEWED

Business

First Name

SHOSHANA

Middle

Last Name

CHURCH

Business Name

SHOSHANA B CHURCH

Original Issue Date

01/28/1993

Effective Date

09/21/2015

Expiration Date

09/30/2017

City

MARION

State

Zip

62959

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

11/01/2017