ASHLEY N LACK Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070019121

License Status

ACTIVE

Business

First Name

ASHLEY

Middle

Last Name

LACK

Business Name

ASHLEY N LACK

Original Issue Date

07/09/2012

Effective Date

07/09/2024

Expiration Date

09/30/2026

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

07/09/2024