NICHOLAS M FORMICA Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160010305

License Status

ACTIVE

Business

First Name

NICHOLAS

Middle

Last Name

FORMICA

Business Name

NICHOLAS M FORMICA

Original Issue Date

11/04/2024

Effective Date

08/19/2025

Expiration Date

09/30/2027

City

HOMETOWN

State

Zip

60456

County

COOK

Ever Disciplined

LastModifiedDate

08/19/2025