SAVANNAH LAUREN DE LA FUENTE Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070026125

License Status

ACTIVE

Business

First Name

SAVANNAH

Middle

LAUREN

Last Name

DE LA FUENTE

Business Name

SAVANNAH LAUREN DE LA FUENTE

Original Issue Date

08/27/2021

Effective Date

09/16/2024

Expiration Date

09/30/2026

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

09/16/2024