NATHANIEL BASCAR VIZCAYNO Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011571

License Status

ACTIVE

Business

First Name

NATHANIEL

Middle

BASCAR

Last Name

VIZCAYNO

Business Name

NATHANIEL BASCAR VIZCAYNO

Original Issue Date

11/01/1999

Effective Date

09/02/2024

Expiration Date

09/30/2026

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

09/02/2024