LOLLETH BAUTISTA GONZALES Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012922

License Status

NOT RENEWED

Business

First Name

LOLLETH

Middle

BAUTISTA

Last Name

GONZALES

Business Name

LOLLETH BAUTISTA GONZALES

Original Issue Date

03/15/2002

Effective Date

09/02/2014

Expiration Date

09/30/2016

City

ROSEVILLE

State

Zip

95747

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

11/26/2016