JENNIFER S LATTA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003553

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

LATTA

Business Name

JENNIFER S LATTA

Original Issue Date

01/21/2000

Effective Date

09/30/2005

Expiration Date

09/30/2007

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

03/25/2008