LA TONYA Y BLACK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004482

License Status

NOT RENEWED

Business

First Name

LA TONYA

Middle

Last Name

BLACK

Business Name

LA TONYA Y BLACK

Original Issue Date

09/30/2005

Effective Date

12/23/2021

Expiration Date

09/30/2023

City

MERRILLVILLE

State

Zip

46410

County

INDIANA

Ever Disciplined

LastModifiedDate

02/02/2024