ANDREW WAYNE JELLEMA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070020408

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

WAYNE

Last Name

JELLEMA

Business Name

ANDREW WAYNE JELLEMA

Original Issue Date

11/14/2013

Effective Date

09/02/2014

Expiration Date

09/30/2016

City

GRIFFITH

State

Zip

46319

County

INDIANA

Ever Disciplined

LastModifiedDate

11/26/2016