STACEY LEE CLARKE - Physical Therapist License in Illinois | # 070017631

STACEY LEE CLARKE

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070017631

License Status

NOT RENEWED

Business

N

First Name

STACEY

Middle

LEE

Last Name

CLARKE

Business Name

STACEY LEE CLARKE

Original Issue Date

02/11/2010

Effective Date

09/22/2010

Expiration Date

09/30/2012

State

IL

Ever Disciplined

N

LastModifiedDate

01/16/2013