KELLIE A BANFIELD Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070019582

License Status

NOT RENEWED

Business

First Name

KELLIE

Middle

Last Name

BANFIELD

Business Name

KELLIE A BANFIELD

Original Issue Date

11/13/2012

Effective Date

09/22/2020

Expiration Date

09/30/2022

City

MORAGA

State

Zip

94556

Ever Disciplined

LastModifiedDate

11/28/2022