AMY M SHACKELFORD Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006572

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

SHACKELFORD

Business Name

AMY M SHACKELFORD

Original Issue Date

10/02/2013

Effective Date

09/29/2023

Expiration Date

09/30/2025

City

TWIN LAKES

State

Zip

53181

County

WISCONSIN

Ever Disciplined

LastModifiedDate

03/16/2026