The holder whose full name is BLACK, JONELLA RENEE,come from EVANSTON IL,hold the Physical Therapist license(NO.05001928A) which status is Expired.
| Name | BLACK, JONELLA RENEE |
|---|---|
| License Number | 05001928A |
| License Type | Physical Therapist |
| License Status | Expired |
| City | EVANSTON |
| State | IL |