BRENDA J TATHAM Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002443

License Status

INACTIVE

Business

First Name

BRENDA J

Last Name

TATHAM

Business Name

BRENDA J TATHAM

Original Issue Date

05/17/1996

Effective Date

08/02/2017

Expiration Date

09/30/2019

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Ever Disciplined

LastModifiedDate

07/04/2019