LAURRI J WALLACE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011445

License Status

NOT RENEWED

Business

First Name

LAURRI

Middle

Last Name

WALLACE

Business Name

LAURRI J WALLACE

Original Issue Date

08/31/1999

Effective Date

08/31/1999

Expiration Date

09/30/2000

City

HANOVER PARK

State

Zip

60103

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005