KELLI RENAE PETTIJOHN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007091

License Status

NOT RENEWED

Business

First Name

KELLI

Middle

RENAE

Last Name

PETTIJOHN

Business Name

KELLI RENAE PETTIJOHN

Original Issue Date

05/05/2015

Effective Date

08/03/2015

Expiration Date

09/30/2017

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/01/2017