VENKATA J M BONGARALA Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011570

License Status

ACTIVE

Business

First Name

VENKATA J

Middle

Last Name

BONGARALA

Business Name

VENKATA J M BONGARALA

Original Issue Date

11/01/1999

Effective Date

08/24/2024

Expiration Date

09/30/2026

City

LINDENHURST

State

Zip

60046

County

LAKE

Ever Disciplined

LastModifiedDate

08/24/2024