KEITA MORIMOTO Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006292

License Status

NOT RENEWED

Business

First Name

KEITA

Last Name

MORIMOTO

Business Name

KEITA MORIMOTO

Original Issue Date

11/29/2012

Effective Date

09/25/2013

Expiration Date

09/30/2015

City

CARBONDALE

State

Zip

62903

County

JACKSON

Ever Disciplined

LastModifiedDate

11/03/2015