TIFFANY SHAUNTE JACKSON-PONDER Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160005716

License Status

INACTIVE

Business

First Name

TIFFANY

Middle

SHAUNTE

Last Name

JACKSON-PONDER

Business Name

TIFFANY SHAUNTE JACKSON-PONDER

Original Issue Date

08/01/2011

Effective Date

08/01/2011

Expiration Date

09/30/2013

City

OKLAHOMA CITY

State

Zip

73114

County

OKLAHOMA

Ever Disciplined

LastModifiedDate

07/03/2013