CHARLE PETHSOMVONG Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160009793

License Status

ACTIVE

Business

First Name

CHARLE

Last Name

PETHSOMVONG

Business Name

CHARLE PETHSOMVONG

Original Issue Date

04/06/2023

Effective Date

09/12/2025

Expiration Date

09/30/2027

City

FRANKLIN PARK

State

Zip

61031

Ever Disciplined

LastModifiedDate

09/12/2025