CAMILO DATU EVANGELISTA Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070016951

License Status

ACTIVE

Business

First Name

CAMILO

Middle

DATU

Last Name

EVANGELISTA

Business Name

CAMILO DATU EVANGELISTA

Original Issue Date

03/02/2009

Effective Date

09/23/2024

Expiration Date

09/30/2026

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

09/23/2024