RICHARD RANDALL KIDWELL Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002360

License Status

INACTIVE

Business

First Name

RICHARD RANDALL

Last Name

KIDWELL

Business Name

RICHARD RANDALL KIDWELL

Original Issue Date

01/13/1977

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

CHESTERFIELD

State

Zip

63017

Ever Disciplined

LastModifiedDate

10/25/2012