BRENT D MACK Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012918

License Status

ACTIVE

Business

First Name

BRENT

Middle

Last Name

MACK

Business Name

BRENT D MACK

Original Issue Date

03/14/2002

Effective Date

07/10/2024

Expiration Date

09/30/2026

City

PLAINFIELD

State

Zip

60585

County

WILL

Ever Disciplined

LastModifiedDate

07/10/2024