MIBSAM LISSETTE HERRERA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004415

License Status

NOT RENEWED

Business

First Name

MIBSAM

Middle

LISSETTE

Last Name

HERRERA

Business Name

MIBSAM LISSETTE HERRERA

Original Issue Date

03/24/2005

Effective Date

09/30/2005

Expiration Date

09/30/2007

City

BLUE ISLAND

State

Zip

60406

County

COOK

Ever Disciplined

LastModifiedDate

03/25/2008