Indiana
Professional Licensing Agency
Jennifer Derham
Physical Therapist
License number
05010360A
Date granted
06/25/2010
Date expires
06/30/2014
Class
Physical Therapist
Status
Expired
Address
South Bend IN 46615
indianalicensing.org
ID 8377809
LAST UPDATED 2024-04-05 09:51:48 UTC
LAST UPDATED 2024-04-05 09:51:48 UTC
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