STACEY MARIE LANE Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070018155

License Status

ACTIVE

Business

First Name

STACEY

Middle

MARIE

Last Name

LANE

Business Name

STACEY MARIE LANE

Original Issue Date

09/29/2010

Effective Date

08/21/2024

Expiration Date

09/30/2026

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Ever Disciplined

LastModifiedDate

08/21/2024