DESTINEE EDEN MOODY Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007712

License Status

ACTIVE

Business

First Name

DESTINEE

Middle

EDEN

Last Name

MOODY

Business Name

DESTINEE EDEN MOODY

Original Issue Date

11/01/2016

Effective Date

09/25/2025

Expiration Date

09/30/2027

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/25/2025