JAN CLARENCE GUTIERREZ DIMLA Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070022794

License Status

ACTIVE

Business

First Name

JAN CLARENCE

Middle

GUTIERREZ

Last Name

DIMLA

Business Name

JAN CLARENCE GUTIERREZ DIMLA

Original Issue Date

02/02/2017

Effective Date

08/30/2024

Expiration Date

09/30/2026

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

08/30/2024