MIDA N BAUTISTA-DITTMAR Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070007736

License Status

ACTIVE

Business

First Name

MIDA N

Last Name

BAUTISTA-DITTMAR

Business Name

MIDA N BAUTISTA-DITTMAR

Original Issue Date

09/14/1993

Effective Date

09/19/2024

Expiration Date

09/30/2026

City

OGLESBY

State

Zip

61348

County

LA SALLE

Ever Disciplined

LastModifiedDate

09/19/2024