HANNA JOHARA MASCARENAS BASA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070018416

License Status

NOT RENEWED

Business

First Name

HANNA JOHARA

Middle

MASCARENAS

Last Name

BASA

Business Name

HANNA JOHARA MASCARENAS BASA

Original Issue Date

06/01/2011

Effective Date

07/17/2018

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

01/14/2021