DERICK M RUSSELL - Physical Therapist License in Illinois | # 070013337

DERICK M RUSSELL

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013337

License Status

ACTIVE

Business

N

First Name

DERICK

Middle

M

Last Name

RUSSELL

Business Name

DERICK M RUSSELL

Original Issue Date

12/20/2002

Effective Date

09/15/2024

Expiration Date

09/30/2026

State

IL

Ever Disciplined

N

LastModifiedDate

09/15/2024