AMANDA MELISSA BRACKROG Physical Therapist License verification

Business Entity

CANCELLED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007433

License Status

CANCELLED

Business

First Name

AMANDA

Middle

MELISSA

Last Name

BRACKROG

Business Name

AMANDA MELISSA BRACKROG

Original Issue Date

03/02/2016

Effective Date

03/02/2016

Expiration Date

09/30/2017

City

SANTEE

State

Zip

92071

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

01/29/2016