License holder summary

Derek Bradley Wallace is a Physical Therapy Committee - Physical Therapist Assistant licensed to practice in Indiana. The address on file for Derek Bradley Wallace is Newburgh IN 47630. This licensed professional license is current. The license was granted 11/29/1995 and expired on 06/30/2016.

Indiana

Professional Licensing Agency

Derek Bradley Wallace
Physical Therapy Committee - Physical Therapist Assistant
License number
06001705A
Date granted
11/29/1995
Date expires
06/30/2016
Class
Physical Therapy Committee - Physical Therapist Assistant
Status
Active
Address
Newburgh IN 47630
indianalicensing.org
ID 8365477
LAST UPDATED 2024-03-28 19:03:51 UTC

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