STEPHANIE R ELLSWORTH Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003834

License Status

INACTIVE

Business

First Name

STEPHANIE

Middle

Last Name

ELLSWORTH

Business Name

STEPHANIE R ELLSWORTH

Original Issue Date

05/03/2001

Effective Date

05/03/2001

Expiration Date

09/30/2005

City

HILLSBORO

State

Zip

62049

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

10/17/2005