STACIE SHAWNE GRANT Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004224

License Status

ACTIVE

Business

First Name

STACIE

Middle

SHAWNE

Last Name

GRANT

Business Name

STACIE SHAWNE GRANT

Original Issue Date

11/17/2003

Effective Date

09/25/2025

Expiration Date

09/30/2027

City

WATERLOO

State

Zip

62298

County

MONROE

Ever Disciplined

LastModifiedDate

09/25/2025