BENJAMIN G HAGEN Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070018871

License Status

INACTIVE

Business

First Name

BENJAMIN

Middle

Last Name

HAGEN

Business Name

BENJAMIN G HAGEN

Original Issue Date

11/16/2011

Effective Date

08/14/2012

Expiration Date

09/30/2014

City

SAINT LOUIS

State

Zip

63119

County

MISSOURI

Ever Disciplined

LastModifiedDate

07/03/2014