ZACHARY JAMES BLAKE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006030

License Status

NOT RENEWED

Business

First Name

ZACHARY

Middle

JAMES

Last Name

BLAKE

Business Name

ZACHARY JAMES BLAKE

Original Issue Date

07/24/2012

Effective Date

07/09/2013

Expiration Date

09/30/2015

City

CASTALIA

State

Zip

44824

County

OHIO

Ever Disciplined

LastModifiedDate

11/03/2015