CARLY M MACHACEK DPT Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006609

License Status

NOT RENEWED

Business

Title

DPT

First Name

CARLY

Middle

Last Name

MACHACEK

Business Name

CARLY M MACHACEK DPT

Original Issue Date

10/29/2013

Effective Date

08/07/2017

Expiration Date

09/30/2019

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

01/13/2020