STACEY L PALMER Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070014630

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

Last Name

PALMER

Business Name

STACEY L PALMER

Original Issue Date

09/15/2005

Effective Date

09/30/2008

Expiration Date

09/30/2010

City

KENOSHA

State

Zip

53142

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/08/2010