NATHANIEL B MANCILLAS Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070022749

License Status

ACTIVE

Business

First Name

NATHANIEL

Middle

Last Name

MANCILLAS

Business Name

NATHANIEL B MANCILLAS

Original Issue Date

12/09/2016

Effective Date

09/11/2024

Expiration Date

09/30/2026

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2024