MIA ANICA K FUENTEBELLA Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070024746

License Status

ACTIVE

Business

First Name

MIA ANICA

Middle

Last Name

FUENTEBELLA

Business Name

MIA ANICA K FUENTEBELLA

Original Issue Date

09/06/2019

Effective Date

09/05/2024

Expiration Date

09/30/2026

City

ORLAND PARK

State

Zip

60462

County

COOK

Ever Disciplined

LastModifiedDate

09/05/2024