DWAYNE E MAXAM Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070010279

License Status

ACTIVE

Business

First Name

DWAYNE E

Last Name

MAXAM

Business Name

DWAYNE E MAXAM

Original Issue Date

10/08/1997

Effective Date

08/20/2024

Expiration Date

09/30/2026

City

WILDWOOD

State

Zip

63021

County

MISSOURI

Ever Disciplined

LastModifiedDate

08/20/2024