SHIRLEY E LACEY Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160000196

License Status

INACTIVE

Business

First Name

SHIRLEY E

Last Name

LACEY

Business Name

SHIRLEY E LACEY

Original Issue Date

07/11/1991

Effective Date

07/11/1991

Expiration Date

09/30/2005

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005