MALLORY ELLEN JACOBS Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006801

License Status

NOT RENEWED

Business

First Name

MALLORY

Middle

ELLEN

Last Name

JACOBS

Business Name

MALLORY ELLEN JACOBS

Original Issue Date

08/05/2014

Effective Date

09/18/2017

Expiration Date

09/30/2019

City

SCHERERVILLE

State

Zip

46375

County

LAKE

Ever Disciplined

LastModifiedDate

01/13/2020