ANITA LYSTAD CABANILLA - Physical Therapist License in New Mexico | # 070000476

ANITA LYSTAD CABANILLA

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070000476

License Status

INACTIVE

Business

N

First Name

ANITA LYSTAD

Last Name

CABANILLA

Business Name

ANITA LYSTAD CABANILLA

Original Issue Date

11/15/1960

Effective Date

11/15/1960

Expiration Date

09/30/1984

State

NM

Ever Disciplined

N

LastModifiedDate

10/14/2005