HAZEL R FERNANDES Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070007327

License Status

NOT RENEWED

Business

First Name

HAZEL R

Last Name

FERNANDES

Business Name

HAZEL R FERNANDES

Original Issue Date

01/07/1993

Effective Date

01/07/1993

Expiration Date

09/30/2002

City

INDIANAPOLIS

State

Zip

46268

County

INDIANA

Ever Disciplined

LastModifiedDate

10/17/2005