BERNARD J BURCZUK JR Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004186

License Status

NOT RENEWED

Business

First Name

BERNARD

Middle

Last Name

BURCZUK

Suffix

Business Name

BERNARD J BURCZUK JR

Original Issue Date

06/27/2003

Effective Date

06/27/2003

Expiration Date

09/30/2005

City

DYER

State

Zip

46311

County

INDIANA

Ever Disciplined

LastModifiedDate

10/17/2005