KIMBERLY A BLANK Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002910

License Status

INACTIVE

Business

First Name

KIMBERLY A

Last Name

BLANK

Business Name

KIMBERLY A BLANK

Original Issue Date

12/29/1997

Effective Date

12/29/1997

Expiration Date

09/30/2005

City

LAKE ORION

State

Zip

48360

County

MICHIGAN

Ever Disciplined

LastModifiedDate

10/17/2005