BETH MARIE GUNDRUM Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070018455

License Status

INACTIVE

Business

First Name

BETH

Middle

MARIE

Last Name

GUNDRUM

Business Name

BETH MARIE GUNDRUM

Original Issue Date

06/22/2011

Effective Date

09/28/2012

Expiration Date

09/30/2014

City

PEWAUKEE

State

Zip

53072

County

WISCONSIN

Ever Disciplined

LastModifiedDate

07/03/2014