MARYANN F STORK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003672

License Status

NOT RENEWED

Business

First Name

MARYANN

Middle

Last Name

STORK

Business Name

MARYANN F STORK

Original Issue Date

09/18/2000

Effective Date

09/23/2023

Expiration Date

09/30/2025

City

FAIRBURY

State

Zip

61739

County

LIVINGSTON

Ever Disciplined

LastModifiedDate

12/30/2025