HEATHER L BLAKE Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012919

License Status

ACTIVE

Business

First Name

HEATHER

Middle

Last Name

BLAKE

Business Name

HEATHER L BLAKE

Original Issue Date

03/14/2002

Effective Date

09/16/2024

Expiration Date

09/30/2026

City

PLAINFIELD

State

Zip

60585

County

KENDALL

Ever Disciplined

LastModifiedDate

09/16/2024