CRYSTAL L GOLLA Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004412

License Status

INACTIVE

Business

First Name

CRYSTAL

Middle

Last Name

GOLLA

Business Name

CRYSTAL L GOLLA

Original Issue Date

03/22/2005

Effective Date

09/30/2005

Expiration Date

09/30/2007

City

ORLANDO

State

Zip

32832

County

FLORIDA

Ever Disciplined

LastModifiedDate

07/05/2007