CLARISSE DAWN BALBONTIN GEMOTO - Physical Therapist License in Illinois | # 070016649

CLARISSE DAWN BALBONTIN GEMOTO

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070016649

License Status

NOT RENEWED

Business

N

First Name

CLARISSE DAWN

Middle

BALBONTIN

Last Name

GEMOTO

Business Name

CLARISSE DAWN BALBONTIN GEMOTO

Original Issue Date

08/26/2008

Effective Date

09/14/2020

Expiration Date

09/30/2022

State

IL

Ever Disciplined

N

LastModifiedDate

11/28/2022