MOLLY ANN WIESEN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070018404

License Status

NOT RENEWED

Business

First Name

MOLLY

Middle

ANN

Last Name

WIESEN

Business Name

MOLLY ANN WIESEN

Original Issue Date

05/24/2011

Effective Date

05/24/2011

Expiration Date

09/30/2012

City

GRAFTON

State

Zip

58237

County

NORTH DAKOTA

Ever Disciplined

LastModifiedDate

01/16/2013