SHELLEY RAE MONGRAIN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012414

License Status

NOT RENEWED

Business

First Name

SHELLEY

Middle

RAE

Last Name

MONGRAIN

Business Name

SHELLEY RAE MONGRAIN

Original Issue Date

04/02/2001

Effective Date

04/02/2001

Expiration Date

09/30/2004

City

OAK PARK

State

Zip

60304

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005