MARY ANN G BREAULT Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070009033

License Status

ACTIVE

Business

First Name

MARY ANN

Middle

Last Name

BREAULT

Business Name

MARY ANN G BREAULT

Original Issue Date

09/07/1995

Effective Date

07/03/2024

Expiration Date

09/30/2026

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/03/2024