MICHAEL GERARD MIKKELSON Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004299

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

GERARD

Last Name

MIKKELSON

Business Name

MICHAEL GERARD MIKKELSON

Original Issue Date

06/03/2004

Effective Date

06/03/2004

Expiration Date

09/30/2005

City

ST PAUL

State

Zip

55105

County

MINNESOTA

Ever Disciplined

LastModifiedDate

10/17/2005