MADONNA M BROQUET Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160001738

License Status

INACTIVE

Business

First Name

MADONNA M

Last Name

BROQUET

Business Name

MADONNA M BROQUET

Original Issue Date

09/18/1993

Effective Date

08/27/2019

Expiration Date

12/31/2021

City

LAKE VILLA

State

Zip

60046

County

LAKE

Ever Disciplined

LastModifiedDate

09/17/2021