TIMOTHY R MOFFITT Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004455

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

Last Name

MOFFITT

Business Name

TIMOTHY R MOFFITT

Original Issue Date

09/01/2005

Effective Date

10/02/2017

Expiration Date

09/30/2019

City

SOUTH BELOIT

State

Zip

61080

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/13/2020