LORI JAYNE BLACK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003735

License Status

NOT RENEWED

Business

First Name

LORI

Middle

JAYNE

Last Name

BLACK

Business Name

LORI JAYNE BLACK

Original Issue Date

11/09/2000

Effective Date

11/09/2000

Expiration Date

09/30/2001

City

PADUCAH

State

Zip

42003

County

KENTUCKY

Ever Disciplined

LastModifiedDate

10/17/2005