LESA ANNE DEJONG Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006192

License Status

NOT RENEWED

Business

First Name

LESA

Middle

ANNE

Last Name

DEJONG

Business Name

LESA ANNE DEJONG

Original Issue Date

10/04/2012

Effective Date

07/15/2013

Expiration Date

09/30/2015

City

SAINT JOHN

State

Zip

46373

County

INDIANA

Ever Disciplined

LastModifiedDate

11/03/2015