NATHAN W JACOBS Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006250

License Status

INACTIVE

Business

First Name

NATHAN

Middle

Last Name

JACOBS

Business Name

NATHAN W JACOBS

Original Issue Date

11/20/2012

Effective Date

07/08/2013

Expiration Date

09/30/2015

City

COAL VALLEY

State

Zip

61240

County

HENRY

Ever Disciplined

LastModifiedDate

07/06/2015