CHARLES BENJAMIN ELY Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007475

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

BENJAMIN

Last Name

ELY

Business Name

CHARLES BENJAMIN ELY

Original Issue Date

05/02/2016

Effective Date

05/02/2016

Expiration Date

09/30/2017

City

CANTON

State

Zip

61520

County

FULTON

Ever Disciplined

LastModifiedDate

11/01/2017