ELIZABETH IDELLA CLARK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003291

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

IDELLA

Last Name

CLARK

Business Name

ELIZABETH IDELLA CLARK

Original Issue Date

01/21/1999

Effective Date

01/21/1999

Expiration Date

09/30/1999

City

MAYFIELD

State

Zip

42066

County

KENTUCKY

Ever Disciplined

LastModifiedDate

10/14/2005