MICHELLE THERESA CUSACK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070021657

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

THERESA

Last Name

CUSACK

Business Name

MICHELLE THERESA CUSACK

Original Issue Date

08/13/2015

Effective Date

08/13/2015

Expiration Date

09/30/2016

City

PORTLAND

State

Zip

04103

County

MAINE

Ever Disciplined

LastModifiedDate

11/26/2016