KRISTINA R RUSSELL Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012225

License Status

ACTIVE

Business

First Name

KRISTINA

Middle

Last Name

RUSSELL

Business Name

KRISTINA R RUSSELL

Original Issue Date

11/27/2000

Effective Date

08/02/2024

Expiration Date

09/30/2026

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

08/02/2024