JENNIFER M MILLER Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004302

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

MILLER

Business Name

JENNIFER M MILLER

Original Issue Date

06/16/2004

Effective Date

06/16/2004

Expiration Date

09/30/2005

City

OCONOMOWOC

State

Zip

53066

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/17/2005