The holder whose full name is BEAVEN, CHARLES JOSEPH,come from Louisville KY,hold the Physical Therapist license(NO.05001692A) which status is Expired.
| Name | BEAVEN, CHARLES JOSEPH |
|---|---|
| License Number | 05001692A |
| License Type | Physical Therapist |
| License Status | Expired |
| City | Louisville |
| State | KY |