The holder whose full name is PARK, ANNETTE JENEANE,come from PEORIA IL,hold the Phys Ther Assistant license(NO.06000731A) which status is Expired.
| Name | PARK, ANNETTE JENEANE |
|---|---|
| License Number | 06000731A |
| License Type | Phys Ther Assistant |
| License Status | Expired |
| City | PEORIA |
| State | IL |