MICHAEL S BLANTON Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003311

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

BLANTON

Business Name

MICHAEL S BLANTON

Original Issue Date

02/23/1999

Effective Date

09/17/2019

Expiration Date

01/31/2022

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/19/2022