LEODELYN ACEBES MATA Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070019063

License Status

INACTIVE

Business

First Name

LEODELYN

Middle

ACEBES

Last Name

MATA

Business Name

LEODELYN ACEBES MATA

Original Issue Date

04/17/2012

Effective Date

09/02/2014

Expiration Date

09/30/2016

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/06/2016