TAMI THERESE WILLARD Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006684

License Status

NOT RENEWED

Business

First Name

TAMI

Middle

THERESE

Last Name

WILLARD

Business Name

TAMI THERESE WILLARD

Original Issue Date

01/08/2014

Effective Date

09/25/2017

Expiration Date

09/30/2019

City

MERRILLVILLE

State

Zip

46410

County

INDIANA

Ever Disciplined

LastModifiedDate

01/13/2020