TRACEE L DE PRIEST Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002564

License Status

NOT RENEWED

Business

First Name

TRACEE L

Last Name

DE PRIEST

Business Name

TRACEE L DE PRIEST

Original Issue Date

11/12/1996

Effective Date

10/02/2017

Expiration Date

09/30/2019

City

BETHALTO

State

Zip

62010

County

MADISON

Ever Disciplined

LastModifiedDate

01/13/2020