ALAN C PROVO Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160003913

License Status

ACTIVE

Business

First Name

ALAN

Middle

Last Name

PROVO

Business Name

ALAN C PROVO

Original Issue Date

09/27/2001

Effective Date

09/08/2025

Expiration Date

09/30/2027

City

TINLEY PARK

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

09/08/2025