ANDREA L MONTGOMERY Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002772

License Status

INACTIVE

Business

First Name

ANDREA

Middle

Last Name

MONTGOMERY

Business Name

ANDREA L MONTGOMERY

Original Issue Date

09/11/1997

Effective Date

09/11/1997

Expiration Date

09/30/2005

City

PAWNEE

State

Zip

62558

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005