AMANDA MELISSA BRACKROG - Physical Therapist License in Illinois | # 070022107

AMANDA MELISSA BRACKROG

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070022107

License Status

NOT RENEWED

Business

N

First Name

AMANDA

Middle

MELISSA

Last Name

BRACKROG

Business Name

AMANDA MELISSA BRACKROG

Original Issue Date

03/29/2016

Effective Date

07/22/2016

Expiration Date

09/30/2018

State

IL

Ever Disciplined

N

LastModifiedDate

12/05/2018