TIFFANY L BLASA Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013674

License Status

ACTIVE

Business

First Name

TIFFANY

Middle

Last Name

BLASA

Business Name

TIFFANY L BLASA

Original Issue Date

10/09/2003

Effective Date

09/05/2024

Expiration Date

09/30/2026

City

GRAFTON

State

Zip

62037

County

JERSEY

Ever Disciplined

LastModifiedDate

09/05/2024