MARA M SPENCER Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070014431

License Status

NOT RENEWED

Business

First Name

MARA

Middle

Last Name

SPENCER

Business Name

MARA M SPENCER

Original Issue Date

05/17/2005

Effective Date

05/17/2005

Expiration Date

09/30/2006

City

PEWAUKEE

State

Zip

53072

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/08/2006