BRADLEY J GREEN Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007925

License Status

INACTIVE

Business

First Name

BRADLEY

Middle

Last Name

GREEN

Business Name

BRADLEY J GREEN

Original Issue Date

08/07/2017

Effective Date

09/20/2019

Expiration Date

12/31/2021

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

12/21/2021