LAURA L WALICZEK Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013623

License Status

INACTIVE

Business

First Name

LAURA

Middle

Last Name

WALICZEK

Business Name

LAURA L WALICZEK

Original Issue Date

09/08/2003

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

PORTLAND

State

Zip

97225

County

WASHINGTON

Ever Disciplined

LastModifiedDate

07/13/2006