GERRY ROGER JIMENEZ BALASTA - Occupational Therapist License in Texas | # 056005494

GERRY ROGER JIMENEZ BALASTA

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005494

License Status

NOT RENEWED

Business

N

First Name

GERRY ROGER

Middle

JIMENEZ

Last Name

BALASTA

Business Name

GERRY ROGER JIMENEZ BALASTA

Original Issue Date

09/28/1999

Effective Date

02/27/2002

Expiration Date

12/31/2001

State

TX

Ever Disciplined

N

LastModifiedDate

09/11/2005