STACEY LEE CLARKE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070017631

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

LEE

Last Name

CLARKE

Business Name

STACEY LEE CLARKE

Original Issue Date

02/11/2010

Effective Date

09/22/2010

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

01/16/2013