LISA L BLACK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070005375

License Status

NOT RENEWED

Business

First Name

LISA L

Last Name

BLACK

Business Name

LISA L BLACK

Original Issue Date

03/05/1988

Effective Date

03/05/1988

Expiration Date

09/30/1990

City

OMAHA

State

Zip

68104

County

NEBRASKA

Ever Disciplined

LastModifiedDate

10/14/2005