STACEY ANN MERRITT Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070014122

License Status

ACTIVE

Business

First Name

STACEY

Middle

ANN

Last Name

MERRITT

Business Name

STACEY ANN MERRITT

Original Issue Date

09/07/2004

Effective Date

08/10/2024

Expiration Date

09/30/2026

City

BLOOMINGTON

State

Zip

61701

Ever Disciplined

LastModifiedDate

08/10/2024