BLAKE W STAHL Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011773

License Status

ACTIVE

Business

First Name

BLAKE

Middle

Last Name

STAHL

Business Name

BLAKE W STAHL

Original Issue Date

03/01/2000

Effective Date

09/17/2024

Expiration Date

09/30/2026

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/17/2024