DYLAN D LUCAS Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007643

License Status

NOT RENEWED

Business

First Name

DYLAN

Middle

Last Name

LUCAS

Business Name

DYLAN D LUCAS

Original Issue Date

08/17/2016

Effective Date

10/01/2019

Expiration Date

01/31/2022

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/19/2022