RENATO LASAM MIGUEL JR Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070019885

License Status

INACTIVE

Business

First Name

RENATO

Middle

LASAM

Last Name

MIGUEL

Suffix

Business Name

RENATO LASAM MIGUEL JR

Original Issue Date

06/12/2013

Effective Date

08/21/2014

Expiration Date

09/30/2016

City

GLENVIEW

State

Zip

60025

County

COOK

Ever Disciplined

LastModifiedDate

07/17/2017