JACELYN A MARCINIAK Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004588

License Status

INACTIVE

Business

First Name

JACELYN

Middle

Last Name

MARCINIAK

Business Name

JACELYN A MARCINIAK

Original Issue Date

06/08/2006

Effective Date

09/30/2005

Expiration Date

09/30/2007

City

KENOSHA

State

Zip

53142

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/04/2007