JERRED E LONG Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003359

License Status

NOT RENEWED

Business

First Name

JERRED

Middle

Last Name

LONG

Business Name

JERRED E LONG

Original Issue Date

06/24/1999

Effective Date

06/24/1999

Expiration Date

09/30/2001

City

ELGIN

State

Zip

60123

County

KANE

Ever Disciplined

LastModifiedDate

10/17/2005