KEVIN MICHAEL GOMEZ BEAUCHEMIN - Physical Therapist License in Idaho | # 160009525

KEVIN MICHAEL GOMEZ BEAUCHEMIN

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160009525

License Status

NOT RENEWED

Business

N

First Name

KEVIN

Middle

MICHAEL

Last Name

GOMEZ BEAUCHEMIN

Business Name

KEVIN MICHAEL GOMEZ BEAUCHEMIN

Original Issue Date

02/15/2022

Effective Date

02/15/2022

Expiration Date

09/30/2023

State

ID

Ever Disciplined

N

LastModifiedDate

02/02/2024