SUSAN K PORT Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004011

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

PORT

Business Name

SUSAN K PORT

Original Issue Date

02/13/2002

Effective Date

07/05/2007

Expiration Date

09/30/2009

City

CRYSTAL FALLS

State

Zip

49920

County

MICHIGAN

Ever Disciplined

LastModifiedDate

11/04/2009