SHANNON BROOK COSTELLA Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012743

License Status

INACTIVE

Business

First Name

SHANNON

Middle

BROOK

Last Name

COSTELLA

Business Name

SHANNON BROOK COSTELLA

Original Issue Date

11/20/2001

Effective Date

11/20/2001

Expiration Date

09/30/2004

City

VALPARAISO

State

Zip

46383

County

INDIANA

Ever Disciplined

LastModifiedDate

09/01/2006