SANDRA L JACOBS Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003197

License Status

NOT RENEWED

Business

First Name

SANDRA

Middle

Last Name

JACOBS

Business Name

SANDRA L JACOBS

Original Issue Date

11/02/1998

Effective Date

11/02/1998

Expiration Date

09/30/2005

City

CLINTON

State

Zip

53525

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/17/2005