GERRY ROGER JIMENEZ BALASTA Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056005494

License Status

NOT RENEWED

Business

First Name

GERRY ROGER

Middle

JIMENEZ

Last Name

BALASTA

Business Name

GERRY ROGER JIMENEZ BALASTA

Original Issue Date

09/28/1999

Effective Date

02/27/2002

Expiration Date

12/31/2001

City

HOUSTON,

State

Zip

77083

County

TEXAS

Ever Disciplined

LastModifiedDate

09/11/2005