TRACY L TRELLO Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003093

License Status

INACTIVE

Business

First Name

TRACY

Middle

Last Name

TRELLO

Business Name

TRACY L TRELLO

Original Issue Date

09/22/1998

Effective Date

09/22/1998

Expiration Date

09/30/2005

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005