DEANA M WALLACE Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070016444

License Status

ACTIVE

Business

First Name

DEANA

Middle

Last Name

WALLACE

Business Name

DEANA M WALLACE

Original Issue Date

06/23/2008

Effective Date

09/16/2024

Expiration Date

09/30/2026

City

CHICAGO

State

Zip

60656

County

COOK

Ever Disciplined

LastModifiedDate

09/16/2024