KIMBERLY G CARRILLO Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003758

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

Last Name

CARRILLO

Business Name

KIMBERLY G CARRILLO

Original Issue Date

11/30/2000

Effective Date

11/30/2000

Expiration Date

09/30/2003

City

PAW PAW

State

Zip

61353

County

DEKALB

Ever Disciplined

LastModifiedDate

10/17/2005