NICHOLE SHANNON BLIESNER Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004926

License Status

NOT RENEWED

Business

First Name

NICHOLE

Middle

SHANNON

Last Name

BLIESNER

Business Name

NICHOLE SHANNON BLIESNER

Original Issue Date

11/30/2007

Effective Date

11/30/2007

Expiration Date

09/30/2009

City

RACINE

State

Zip

53405

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/04/2009