JERRED E LONG - Physical Therapist License in Illinois | # 160003359

JERRED E LONG

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003359

License Status

NOT RENEWED

Business

N

First Name

JERRED

Middle

E

Last Name

LONG

Business Name

JERRED E LONG

Original Issue Date

06/24/1999

Effective Date

06/24/1999

Expiration Date

09/30/2001

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005