SHANNON J POTTER Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004046

License Status

INACTIVE

Business

First Name

SHANNON

Middle

Last Name

POTTER

Business Name

SHANNON J POTTER

Original Issue Date

04/30/2002

Effective Date

04/30/2002

Expiration Date

09/30/2003

City

EAST MOLINE

State

Zip

61244

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

10/17/2005