MARY ELLEN EVANS Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070003177

License Status

NOT RENEWED

Business

First Name

MARY ELLEN

Last Name

EVANS

Business Name

MARY ELLEN EVANS

Original Issue Date

05/21/1980

Effective Date

10/01/2006

Expiration Date

09/30/2008

City

HARTFORD

State

Zip

53027

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/06/2008