MAVURA A MUKONA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011197

License Status

NOT RENEWED

Business

First Name

MAVURA

Middle

Last Name

MUKONA

Business Name

MAVURA A MUKONA

Original Issue Date

03/12/1999

Effective Date

03/12/1999

Expiration Date

09/30/2004

City

FORT WAYNE

State

Zip

46835

County

INDIANA

Ever Disciplined

LastModifiedDate

10/17/2005