GABRIELLE ELYSE JACKSON Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007936

License Status

INACTIVE

Business

First Name

GABRIELLE

Middle

ELYSE

Last Name

JACKSON

Business Name

GABRIELLE ELYSE JACKSON

Original Issue Date

08/08/2017

Effective Date

09/09/2021

Expiration Date

09/30/2023

City

SULLIVAN

State

Zip

61951

County

MOULTRIE

Ever Disciplined

LastModifiedDate

08/10/2023