MARYELLEN M PETRIE Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070019423

License Status

NOT RENEWED

Business

First Name

MARYELLEN

Middle

Last Name

PETRIE

Business Name

MARYELLEN M PETRIE

Original Issue Date

08/21/2012

Effective Date

09/30/2016

Expiration Date

09/30/2018

City

KIRKWOOD

State

Zip

63122

County

COOK

Ever Disciplined

LastModifiedDate

12/05/2018