KELLY A IMHOFF Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004479

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

IMHOFF

Business Name

KELLY A IMHOFF

Original Issue Date

09/30/2005

Effective Date

09/11/2017

Expiration Date

09/30/2019

City

GRANITE CITY

State

Zip

62040

County

MADISON

Ever Disciplined

LastModifiedDate

01/13/2020