JUNZEN BALLESIL DOMINGO - Physical Therapist License in Illinois | # 070018428

JUNZEN BALLESIL DOMINGO

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070018428

License Status

NOT RENEWED

Business

N

First Name

JUNZEN

Middle

BALLESIL

Last Name

DOMINGO

Business Name

JUNZEN BALLESIL DOMINGO

Original Issue Date

06/02/2011

Effective Date

09/11/2012

Expiration Date

09/30/2014

State

IL

Ever Disciplined

N

LastModifiedDate

11/17/2014