MARY ELLEN MODICA Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070003777

License Status

ACTIVE

Business

First Name

MARY ELLEN

Last Name

MODICA

Business Name

MARY ELLEN MODICA

Original Issue Date

11/08/1982

Effective Date

08/04/2024

Expiration Date

09/30/2026

City

CHICAGO

State

Zip

60639

County

COOK

Ever Disciplined

LastModifiedDate

08/04/2024