STACIE R MICELI Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011318

License Status

ACTIVE

Business

First Name

STACIE

Middle

Last Name

MICELI

Business Name

STACIE R MICELI

Original Issue Date

05/13/1999

Effective Date

07/31/2024

Expiration Date

09/30/2026

City

WAUCONDA

State

Zip

60084

County

KENDALL

Ever Disciplined

LastModifiedDate

07/31/2024