RAE L CROUCH Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003118

License Status

INACTIVE

Business

First Name

RAE

Middle

Last Name

CROUCH

Business Name

RAE L CROUCH

Original Issue Date

10/01/1998

Effective Date

07/04/2019

Expiration Date

12/31/2021

City

GRANITE CITY

State

Zip

62040

County

MADISON

Ever Disciplined

LastModifiedDate

12/31/2021