ALEXIS BELMAR MIRAZOL DELA PENA Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070026334

License Status

INACTIVE

Business

First Name

ALEXIS BELMAR

Middle

MIRAZOL

Last Name

DELA PENA

Business Name

ALEXIS BELMAR MIRAZOL DELA PENA

Original Issue Date

11/04/2021

Effective Date

11/04/2021

Expiration Date

09/30/2022

City

HUMBOLDT

State

Zip

50548

Ever Disciplined

LastModifiedDate

09/23/2022