EILEEN G DIEZ Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004696

License Status

NOT RENEWED

Business

First Name

EILEEN

Middle

Last Name

DIEZ

Business Name

EILEEN G DIEZ

Original Issue Date

11/06/2006

Effective Date

12/30/2021

Expiration Date

09/30/2023

City

CHICAGO

State

Zip

60656

County

COOK

Ever Disciplined

LastModifiedDate

02/02/2024