MARY ANN DIX DESTRO Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002209

License Status

NOT RENEWED

Business

First Name

MARY ANN DIX

Last Name

DESTRO

Business Name

MARY ANN DIX DESTRO

Original Issue Date

06/08/1976

Effective Date

06/08/1976

City

DEKALB

State

Zip

60115

County

DEKALB

Ever Disciplined

LastModifiedDate

10/14/2005