STACIE DAWN CHAMBLISS - Physical Therapist License in Illinois | # 160003293

STACIE DAWN CHAMBLISS

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003293

License Status

NOT RENEWED

Business

N

First Name

STACIE

Middle

DAWN

Last Name

CHAMBLISS

Business Name

STACIE DAWN CHAMBLISS

Original Issue Date

01/28/1999

Effective Date

07/05/2007

Expiration Date

09/30/2009

State

IL

Ever Disciplined

N

LastModifiedDate

11/04/2009