CODY J WICKENHAUSER Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070021534

License Status

ACTIVE

Business

First Name

CODY

Middle

Last Name

WICKENHAUSER

Business Name

CODY J WICKENHAUSER

Original Issue Date

08/10/2015

Effective Date

07/29/2024

Expiration Date

09/30/2026

City

DANVERS

State

Zip

61732

County

MCLEAN

Ever Disciplined

LastModifiedDate

07/29/2024