STEPHEN STANLEY POTISUK Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011469

License Status

ACTIVE

Business

First Name

STEPHEN

Middle

STANLEY

Last Name

POTISUK

Business Name

STEPHEN STANLEY POTISUK

Original Issue Date

09/13/1999

Effective Date

09/22/2024

Expiration Date

09/30/2026

City

ST CHARLES

State

Zip

60175

County

KANE

Ever Disciplined

LastModifiedDate

09/22/2024