DERVILA M FENNELL Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070002975

License Status

NOT RENEWED

Business

First Name

DERVILA M

Last Name

FENNELL

Business Name

DERVILA M FENNELL

Original Issue Date

11/20/1979

Effective Date

11/20/1979

Expiration Date

08/01/1982

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

10/14/2005