MARIA J FAIRBERT Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160001666

License Status

NOT RENEWED

Business

First Name

MARIA

Middle

Last Name

FAIRBERT

Business Name

MARIA J FAIRBERT

Original Issue Date

03/01/1993

Effective Date

03/01/1993

Expiration Date

09/30/2005

City

TONY

State

Zip

54563

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/17/2005