The holder whose full name is BLAKEY, DOUGLAS BERT,come from DECATUR IL,hold the Phys Ther Assistant license(NO.06000702A) which status is Expired.
| Name | BLAKEY, DOUGLAS BERT |
|---|---|
| License Number | 06000702A |
| License Type | Phys Ther Assistant |
| License Status | Expired |
| City | DECATUR |
| State | IL |