JACQUELINE D ICE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002884

License Status

NOT RENEWED

Business

First Name

JACQUELINE D

Last Name

ICE

Business Name

JACQUELINE D ICE

Original Issue Date

11/14/1997

Effective Date

10/02/2017

Expiration Date

09/30/2019

City

SALEM

State

Zip

62881

County

MARION

Ever Disciplined

LastModifiedDate

01/13/2020