Idaho
Division of Occupational and Professional Licenses
SHANE ANTHONY CHAMPION
Physical Therapy Licensure Board - Physical Therapist Assistant
License number
PTA - 2846
Date granted
05/11/2011
Date expires
06/04/2017
Class
Physical Therapy Licensure Board - Physical Therapist Assistant
Status
Current
Address
LEWISTON ID 83501
idaholicensing.com
ID 43733886
LAST UPDATED 2024-02-07 06:59:40 UTC
LAST UPDATED 2024-02-07 06:59:40 UTC
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