JILLIAN ANN STAPLEMAN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004318

License Status

NOT RENEWED

Business

First Name

JILLIAN

Middle

ANN

Last Name

STAPLEMAN

Business Name

JILLIAN ANN STAPLEMAN

Original Issue Date

08/23/2004

Effective Date

07/05/2007

Expiration Date

09/30/2009

City

RACINE

State

Zip

53406

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/04/2009