BRENTON OLSON LATTA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070022132

License Status

NOT RENEWED

Business

First Name

BRENTON

Middle

OLSON

Last Name

LATTA

Business Name

BRENTON OLSON LATTA

Original Issue Date

05/06/2016

Effective Date

08/10/2016

Expiration Date

09/30/2018

City

PALM COAST

State

Zip

32137

County

FLORIDA

Ever Disciplined

LastModifiedDate

12/05/2018