DIANE M BULLOCK Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003333

License Status

ACTIVE

Business

First Name

DIANE

Middle

Last Name

BULLOCK

Business Name

DIANE M BULLOCK

Original Issue Date

04/08/1999

Effective Date

07/08/2025

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60707

County

COOK

Ever Disciplined

LastModifiedDate

07/08/2025