JACOB T VAN PELT Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007871

License Status

NOT RENEWED

Business

First Name

JACOB

Middle

Last Name

VAN PELT

Business Name

JACOB T VAN PELT

Original Issue Date

07/27/2017

Effective Date

07/27/2017

Expiration Date

09/30/2019

City

CHAMPAIGN

State

Zip

61821

Ever Disciplined

LastModifiedDate

01/13/2020