AUGUSTIN DE ASIS BANAYLO JR - Physical Therapist License in Michigan | # 070010953

AUGUSTIN DE ASIS BANAYLO JR

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070010953

License Status

NOT RENEWED

Business

N

First Name

AUGUSTIN

Middle

DE ASIS

Last Name

BANAYLO

Suffix

JR

Business Name

AUGUSTIN DE ASIS BANAYLO JR

Original Issue Date

10/29/1998

Effective Date

10/29/1998

Expiration Date

09/30/2000

State

MI

Ever Disciplined

N

LastModifiedDate

10/17/2005