LACY J SUSLEE Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004311

License Status

ACTIVE

Business

First Name

LACY

Middle

Last Name

SUSLEE

Business Name

LACY J SUSLEE

Original Issue Date

08/10/2004

Effective Date

08/20/2025

Expiration Date

09/30/2027

City

NOKOMIS

State

Zip

62075

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

08/20/2025