MONNETT PETILOS Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012811

License Status

NOT RENEWED

Business

First Name

MONNETT

Last Name

PETILOS

Business Name

MONNETT PETILOS

Original Issue Date

01/08/2002

Effective Date

01/08/2002

Expiration Date

09/30/2002

City

FORT WAYNE

State

Zip

46845

Ever Disciplined

LastModifiedDate

10/17/2005