PONCIANO ENTIERRO PORMENTIRA JR Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070015245

License Status

NOT RENEWED

Business

First Name

PONCIANO

Middle

ENTIERRO

Last Name

PORMENTIRA

Suffix

Business Name

PONCIANO ENTIERRO PORMENTIRA JR

Original Issue Date

08/21/2006

Effective Date

09/26/2014

Expiration Date

09/30/2016

City

FLORA

State

Zip

62839

County

CLAY

Ever Disciplined

LastModifiedDate

11/26/2016