STACY M PANNBACKER Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006282

License Status

NOT RENEWED

Business

First Name

STACY

Middle

Last Name

PANNBACKER

Business Name

STACY M PANNBACKER

Original Issue Date

11/27/2012

Effective Date

07/19/2013

Expiration Date

09/30/2015

City

GIFFORD

State

Zip

61847

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/03/2015