WALLACE K SMITH Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160000336

License Status

NOT RENEWED

Business

First Name

WALLACE K

Last Name

SMITH

Business Name

WALLACE K SMITH

Original Issue Date

08/09/1991

Effective Date

09/04/2019

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

05/19/2022