MAXON SOUVANNASING Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160008802

License Status

ACTIVE

Business

First Name

MAXON

Last Name

SOUVANNASING

Business Name

MAXON SOUVANNASING

Original Issue Date

10/28/2019

Effective Date

09/30/2025

Expiration Date

09/30/2027

City

NORTH AURORA

State

Zip

60542

County

KANE

Ever Disciplined

LastModifiedDate

09/30/2025