CLARK O VANDEGRAFT Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007978

License Status

ACTIVE

Business

First Name

CLARK

Middle

Last Name

VANDEGRAFT

Business Name

CLARK O VANDEGRAFT

Original Issue Date

08/10/2017

Effective Date

09/30/2025

Expiration Date

09/30/2027

City

MARQUETTE HEIGHTS

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/30/2025