JAMIE M DIESTELHORST Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160005560

License Status

NOT RENEWED

Business

First Name

JAMIE

Middle

Last Name

DIESTELHORST

Business Name

JAMIE M DIESTELHORST

Original Issue Date

10/05/2010

Effective Date

10/02/2017

Expiration Date

09/30/2019

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

01/13/2020