CLARISSA A RANDOLPH Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013873

License Status

INACTIVE

Business

First Name

CLARISSA

Middle

Last Name

RANDOLPH

Business Name

CLARISSA A RANDOLPH

Original Issue Date

03/31/2004

Effective Date

10/03/2016

Expiration Date

09/30/2018

City

MISSION

State

Zip

66202

County

KANSAS

Ever Disciplined

LastModifiedDate

07/07/2018