BROOKE C BLACKBURN ELLIS Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004656

License Status

ACTIVE

Business

First Name

BROOKE

Middle

Last Name

BLACKBURN ELLIS

Business Name

BROOKE C BLACKBURN ELLIS

Original Issue Date

09/27/2006

Effective Date

09/12/2025

Expiration Date

09/30/2027

City

WHEATLAND

State

Zip

47597

Ever Disciplined

LastModifiedDate

09/12/2025