BRENDA LAVONNE GREEN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003782

License Status

NOT RENEWED

Business

First Name

BRENDA

Middle

LAVONNE

Last Name

GREEN

Business Name

BRENDA LAVONNE GREEN

Original Issue Date

12/22/2000

Effective Date

12/22/2000

Expiration Date

09/30/2005

City

NAPERVILLE

State

Zip

60565

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/17/2005