STACIE DAWN CHAMBLISS Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003293

License Status

NOT RENEWED

Business

First Name

STACIE

Middle

DAWN

Last Name

CHAMBLISS

Business Name

STACIE DAWN CHAMBLISS

Original Issue Date

01/28/1999

Effective Date

07/05/2007

Expiration Date

09/30/2009

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

11/04/2009