TIFFANY MARIE PETERSEN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004462

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

MARIE

Last Name

PETERSEN

Business Name

TIFFANY MARIE PETERSEN

Original Issue Date

09/06/2005

Effective Date

10/13/2020

Expiration Date

01/31/2022

City

ROBINSON

State

Zip

62454

County

CRAWFORD

Ever Disciplined

LastModifiedDate

05/19/2022