DANIELLE R BULTEMA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004602

License Status

NOT RENEWED

Business

First Name

DANIELLE

Middle

Last Name

BULTEMA

Business Name

DANIELLE R BULTEMA

Original Issue Date

07/27/2006

Effective Date

09/30/2015

Expiration Date

09/30/2017

City

DYER

State

Zip

46311

County

INDIANA

Ever Disciplined

LastModifiedDate

11/01/2017