MARY ELLEN GOUGH Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070021402

License Status

NOT RENEWED

Business

First Name

MARY

Middle

ELLEN

Last Name

GOUGH

Business Name

MARY ELLEN GOUGH

Original Issue Date

06/30/2015

Effective Date

10/03/2016

Expiration Date

09/30/2018

City

CLINTON TOWNSHIP

State

Zip

48038

County

MICHIGAN

Ever Disciplined

LastModifiedDate

12/05/2018