TRACY L CLARK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002622

License Status

NOT RENEWED

Business

First Name

TRACY L

Last Name

CLARK

Business Name

TRACY L CLARK

Original Issue Date

01/09/1997

Effective Date

01/09/1997

Expiration Date

09/30/2005

City

MARYLAND HEIGHTS

State

Zip

63043

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/17/2005