DENISE DIANE WILLARDSEN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011852

License Status

NOT RENEWED

Business

First Name

DENISE

Middle

DIANE

Last Name

WILLARDSEN

Business Name

DENISE DIANE WILLARDSEN

Original Issue Date

03/27/2000

Effective Date

03/27/2000

Expiration Date

09/30/2002

City

CASPER

State

Zip

82601

County

WYOMING

Ever Disciplined

LastModifiedDate

10/17/2005