JENNIFER ANN GOTHAM Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070022761

License Status

INACTIVE

Business

First Name

JENNIFER

Middle

ANN

Last Name

GOTHAM

Business Name

JENNIFER ANN GOTHAM

Original Issue Date

12/19/2016

Effective Date

12/19/2016

Expiration Date

09/30/2018

City

JEFFERSON CITY

State

Zip

65101

County

MISSOURI

Ever Disciplined

LastModifiedDate

07/07/2018