SHAUNA SLACK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160008189

License Status

NOT RENEWED

Business

First Name

SHAUNA

Last Name

SLACK

Business Name

SHAUNA SLACK

Original Issue Date

04/19/2018

Effective Date

04/19/2018

Expiration Date

09/30/2019

City

MADISON

State

Zip

53711

Ever Disciplined

LastModifiedDate

01/13/2020