DOUGLAS A WIERENGA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006179

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

Last Name

WIERENGA

Business Name

DOUGLAS A WIERENGA

Original Issue Date

09/04/2012

Effective Date

09/16/2013

Expiration Date

09/30/2015

City

TINLEY PARK

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

11/03/2015