MATILDA DIJENG Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070008095

License Status

NOT RENEWED

Business

First Name

MATILDA

Last Name

DIJENG

Business Name

MATILDA DIJENG

Original Issue Date

03/14/1994

Effective Date

03/14/1994

Expiration Date

09/30/1996

City

GREENWOOD

State

Zip

46142

County

INDIANA

Ever Disciplined

LastModifiedDate

10/14/2005