IVY MAE FETALINO Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004301

License Status

NOT RENEWED

Business

First Name

IVY

Middle

MAE

Last Name

FETALINO

Business Name

IVY MAE FETALINO

Original Issue Date

06/08/2004

Effective Date

01/06/2010

Expiration Date

09/30/2011

City

AVON PARK

State

Zip

33825

County

FLORIDA

Ever Disciplined

LastModifiedDate

11/04/2011