TANYA M WOLFGRAM Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002165

License Status

NOT RENEWED

Business

First Name

TANYA M

Last Name

WOLFGRAM

Business Name

TANYA M WOLFGRAM

Original Issue Date

05/06/1995

Effective Date

05/06/1995

Expiration Date

09/30/2005

City

PORT WASHINGTON

State

Zip

53074

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/17/2005