GWEN D WEIDELL Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002290

License Status

NOT RENEWED

Business

First Name

GWEN D

Last Name

WEIDELL

Business Name

GWEN D WEIDELL

Original Issue Date

09/19/1995

Effective Date

09/30/2019

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60645

County

COOK

Ever Disciplined

LastModifiedDate

05/19/2022

Case Number

2021008537

Action

Suspension

Discipline Start Date

12/20/2021

Discipline End Date

01/06/2022

Discipline Reason

Failure to file and/or pay Illinois state income taxes. Notice of tax deficiency release received from Department of Revenue on 01/07/2022.