RUSSELL JOHN WARREN Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070009863

License Status

INACTIVE

Business

First Name

RUSSELL JOHN

Last Name

WARREN

Business Name

RUSSELL JOHN WARREN

Original Issue Date

12/12/1996

Effective Date

12/12/1996

Expiration Date

09/30/2004

City

YAPHANK

State

Zip

11980

County

NEW YORK

Ever Disciplined

LastModifiedDate

09/01/2006