Idaho
Division of Occupational and Professional Licenses
JACOB DOUGLAS PENROSE
Physical Therapy Licensure Board - Physical Therapist
License number
PT - 2074
Date granted
05/30/2006
Date expires
05/08/2012
Class
Physical Therapy Licensure Board - Physical Therapist
Status
Not Current
Address
Ammon ID 83406
idaholicensing.com
ID 43732661
LAST UPDATED 2024-05-02 09:41:21 UTC
LAST UPDATED 2024-05-02 09:41:21 UTC
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