SUSAN T BOLAND Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070004245

License Status

NOT RENEWED

Business

First Name

SUSAN T

Last Name

BOLAND

Business Name

SUSAN T BOLAND

Original Issue Date

07/02/1984

Effective Date

07/02/1984

Expiration Date

09/30/1988

City

WAUWATOSA

State

Zip

53213

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/14/2005