GRACIE J KRUCKEBERG Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006125

License Status

ACTIVE

Business

First Name

GRACIE

Middle

Last Name

KRUCKEBERG

Business Name

GRACIE J KRUCKEBERG

Original Issue Date

08/13/2012

Effective Date

10/01/2025

Expiration Date

09/30/2027

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

10/01/2025