JEROME LUCENA AMANQUITON - Physical Therapist License in Illinois | # 070014784

JEROME LUCENA AMANQUITON

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070014784

License Status

NOT RENEWED

Business

N

First Name

JEROME

Middle

LUCENA

Last Name

AMANQUITON

Business Name

JEROME LUCENA AMANQUITON

Original Issue Date

12/21/2005

Effective Date

10/01/2006

Expiration Date

09/30/2008

State

IL

Ever Disciplined

N

LastModifiedDate

11/06/2008