SHAWN M WAGSTAFF Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070010107

License Status

NOT RENEWED

Business

First Name

SHAWN M

Last Name

WAGSTAFF

Business Name

SHAWN M WAGSTAFF

Original Issue Date

05/03/1997

Effective Date

05/03/1997

Expiration Date

09/30/1998

City

LAYTON

State

Zip

84040

County

UTAH

Ever Disciplined

LastModifiedDate

10/14/2005