JUNZEN BALLESIL DOMINGO Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070018428

License Status

NOT RENEWED

Business

First Name

JUNZEN

Middle

BALLESIL

Last Name

DOMINGO

Business Name

JUNZEN BALLESIL DOMINGO

Original Issue Date

06/02/2011

Effective Date

09/11/2012

Expiration Date

09/30/2014

City

ZION

State

Zip

60099

County

LAKE

Ever Disciplined

LastModifiedDate

11/17/2014