KELLY ANN RENEE TALTY Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160005398

License Status

NOT RENEWED

Business

First Name

KELLY ANN

Middle

RENEE

Last Name

TALTY

Business Name

KELLY ANN RENEE TALTY

Original Issue Date

01/27/2010

Effective Date

09/30/2015

Expiration Date

09/30/2017

City

KENOSHA

State

Zip

53143

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/01/2017