AUTUMN K GILLIBRAND Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004043

License Status

NOT RENEWED

Business

First Name

AUTUMN

Middle

Last Name

GILLIBRAND

Business Name

AUTUMN K GILLIBRAND

Original Issue Date

04/23/2002

Effective Date

09/18/2013

Expiration Date

09/30/2015

City

LEROY

State

Zip

61752

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/03/2015