TARA JAN FOULKE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070017138

License Status

NOT RENEWED

Business

First Name

TARA

Middle

JAN

Last Name

FOULKE

Business Name

TARA JAN FOULKE

Original Issue Date

06/10/2009

Effective Date

06/10/2009

Expiration Date

09/30/2010

City

CLOVERDALE

State

Zip

46120

County

INDIANA

Ever Disciplined

LastModifiedDate

11/08/2010