GIAN CARLO MABANTA MORALES Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070022623

License Status

ACTIVE

Business

First Name

GIAN CARLO

Middle

MABANTA

Last Name

MORALES

Business Name

GIAN CARLO MABANTA MORALES

Original Issue Date

08/30/2016

Effective Date

08/25/2024

Expiration Date

09/30/2026

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

08/25/2024