MARYBETH ANSELMO Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160000998

License Status

NOT RENEWED

Business

First Name

MARYBETH

Last Name

ANSELMO

Business Name

MARYBETH ANSELMO

Original Issue Date

11/18/1991

Effective Date

09/10/2015

Expiration Date

09/30/2017

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/01/2017