MARY J RUSSELL Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002134

License Status

NOT RENEWED

Business

First Name

MARY J

Last Name

RUSSELL

Business Name

MARY J RUSSELL

Original Issue Date

01/16/1976

Effective Date

01/16/1976

Expiration Date

09/30/2004

City

MAPLE GROVE

State

Zip

55311

County

MINNESOTA

Ever Disciplined

LastModifiedDate

10/17/2005