JUDITH A DISRUD Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007498

License Status

NOT RENEWED

Business

First Name

JUDITH

Middle

Last Name

DISRUD

Business Name

JUDITH A DISRUD

Original Issue Date

06/17/2016

Effective Date

06/17/2016

Expiration Date

09/30/2017

City

MONTICELLO

State

Zip

53570

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/01/2017