Commission Detail

Notary ID: 1101388
Last Name: White
First Name: Terri
Middle Name: L.
Birth Date: 2/8/XX
Transaction Type: NEW
Certificate: DD 468601
Status: HLD
Issue Date: 09/07/05
Expire Date: 09/06/09
Bonding Agency: 1st State Insurance
Mailing Address: Physical Medicine Center
14522 University Point Pl.
TAMPA, FL 33613-0000


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Florida Department of State Division of Corporations
P.O. Box 6327
Tallahassee, FL. 32314
Phone (850) 245-6975