ETHAN ERIC PETTIWAY Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070014987

License Status

ACTIVE

Business

First Name

ETHAN

Middle

ERIC

Last Name

PETTIWAY

Business Name

ETHAN ERIC PETTIWAY

Original Issue Date

04/04/2006

Effective Date

07/10/2024

Expiration Date

09/30/2026

City

CHICAGO

State

Zip

60654

County

COOK

Ever Disciplined

LastModifiedDate

07/10/2024