MATTHEW LEE DEBOLT - Physical Therapist License in Indiana | # 160006337

MATTHEW LEE DEBOLT

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006337

License Status

NOT RENEWED

Business

N

First Name

MATTHEW

Middle

LEE

Last Name

DEBOLT

Business Name

MATTHEW LEE DEBOLT

Original Issue Date

02/05/2013

Effective Date

08/24/2017

Expiration Date

09/30/2019

State

IN

Ever Disciplined

N

LastModifiedDate

01/13/2020