MAYNARD V UTAYDE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070010354

License Status

NOT RENEWED

Business

First Name

MAYNARD V

Last Name

UTAYDE

Business Name

MAYNARD V UTAYDE

Original Issue Date

11/24/1997

Effective Date

11/24/1997

Expiration Date

09/30/1998

City

FORT WAYNE

State

Zip

46825

County

INDIANA

Ever Disciplined

LastModifiedDate

10/14/2005