K SLADE DIETZ Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002737

License Status

NOT RENEWED

Business

First Name

Middle

SLADE

Last Name

DIETZ

Business Name

K SLADE DIETZ

Original Issue Date

07/31/1997

Effective Date

07/09/2009

Expiration Date

09/30/2011

City

MILLSTADT

State

Zip

62260

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

11/04/2011