KELLY C BASILE - Physical Therapist License in Illinois | # 070014946

KELLY C BASILE

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070014946

License Status

INACTIVE

Business

N

First Name

KELLY

Middle

C

Last Name

BASILE

Business Name

KELLY C BASILE

Original Issue Date

03/22/2006

Effective Date

08/11/2008

Expiration Date

09/30/2010

State

IL

Ever Disciplined

N

LastModifiedDate

07/08/2010