The holder whose full name is LACEY, SHIRLEY ELAINE,come from PEORIA IL,hold the Phys Ther Assistant license(NO.06000494A) which status is Expired.
| Name | LACEY, SHIRLEY ELAINE |
|---|---|
| License Number | 06000494A |
| License Type | Phys Ther Assistant |
| License Status | Expired |
| City | PEORIA |
| State | IL |