KEZIAH LOREN PASCUAL SHAN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070019042

License Status

NOT RENEWED

Business

First Name

KEZIAH LOREN

Middle

PASCUAL

Last Name

SHAN

Business Name

KEZIAH LOREN PASCUAL SHAN

Original Issue Date

04/09/2012

Effective Date

07/05/2012

Expiration Date

09/30/2014

City

CASSELBERRY

State

Zip

32707

County

FLORIDA

Ever Disciplined

LastModifiedDate

11/17/2014