CARISSA DAWN WEAVER Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004269

License Status

INACTIVE

Business

First Name

CARISSA

Middle

DAWN

Last Name

WEAVER

Business Name

CARISSA DAWN WEAVER

Original Issue Date

02/06/2004

Effective Date

09/30/2019

Expiration Date

12/31/2021

City

ALBION

State

Zip

62806

County

EDWARDS

Ever Disciplined

LastModifiedDate

09/09/2021