STACEY A WEAVER Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070019177

License Status

ACTIVE

Business

First Name

STACEY

Middle

Last Name

WEAVER

Business Name

STACEY A WEAVER

Original Issue Date

07/27/2012

Effective Date

08/13/2024

Expiration Date

09/30/2026

City

KIRKLAND

State

Zip

60146

County

DEKALB

Ever Disciplined

LastModifiedDate

08/13/2024