KERMALENE M ELLSWORTH Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004012

License Status

NOT RENEWED

Business

First Name

KERMALENE

Middle

Last Name

ELLSWORTH

Business Name

KERMALENE M ELLSWORTH

Original Issue Date

02/13/2002

Effective Date

10/02/2023

Expiration Date

09/30/2025

City

POPLAR GROVE

State

Zip

61065

County

BOONE

Ever Disciplined

LastModifiedDate

12/30/2025