The holder whose full name is Back, Connie Lynn,come from Fisherville KY,hold the Physical Therapist license(NO.05009630A) which status is Expired.
| Name | Back, Connie Lynn |
|---|---|
| License Number | 05009630A |
| License Type | Physical Therapist |
| License Status | Expired |
| City | Fisherville |
| State | KY |