MARY C LACK - Physical Therapist License in Illinois | # 160006251

MARY C LACK

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006251

License Status

NOT RENEWED

Business

N

First Name

MARY

Middle

C

Last Name

LACK

Business Name

MARY C LACK

Original Issue Date

11/20/2012

Effective Date

08/15/2019

Expiration Date

01/31/2022

State

IL

Ever Disciplined

N

LastModifiedDate

05/19/2022