GRACIELA LATUPAN BAMBALAN - Physical Therapist License in New Jersey | # 070021437

GRACIELA LATUPAN BAMBALAN

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070021437

License Status

INACTIVE

Business

N

First Name

GRACIELA

Middle

LATUPAN

Last Name

BAMBALAN

Business Name

GRACIELA LATUPAN BAMBALAN

Original Issue Date

07/21/2015

Effective Date

08/24/2020

Expiration Date

09/30/2022

State

NJ

Ever Disciplined

N

LastModifiedDate

06/30/2022