SAMANTHA LYNN GUSTAFSON Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160009541

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

LYNN

Last Name

GUSTAFSON

Business Name

SAMANTHA LYNN GUSTAFSON

Original Issue Date

04/13/2022

Effective Date

08/29/2023

Expiration Date

09/30/2025

City

BRADLEY

State

Zip

60915

County

KANKAKEE

Ever Disciplined

LastModifiedDate

12/30/2025