NATHANIEL L PENA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070006621

License Status

NOT RENEWED

Business

First Name

NATHANIEL L

Last Name

PENA

Business Name

NATHANIEL L PENA

Original Issue Date

09/19/1991

Effective Date

09/19/1991

Expiration Date

09/30/1994

City

ZION

State

Zip

60099

County

LAKE

Ever Disciplined

LastModifiedDate

10/14/2005