MAE O PEDROSO PROVO Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070009066

License Status

ACTIVE

Business

First Name

MAE O

Middle

PEDROSO

Last Name

PROVO

Business Name

MAE O PEDROSO PROVO

Original Issue Date

09/12/1995

Effective Date

08/25/2024

Expiration Date

09/30/2026

City

TINLEY PARK

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

08/25/2024