DEREK W BUSS Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160005397

License Status

NOT RENEWED

Business

First Name

DEREK

Middle

Last Name

BUSS

Business Name

DEREK W BUSS

Original Issue Date

01/26/2010

Effective Date

07/27/2017

Expiration Date

09/30/2019

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/13/2020