DANIEL L PRUDENCIO Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004507

License Status

ACTIVE

Business

First Name

DANIEL

Middle

Last Name

PRUDENCIO

Business Name

DANIEL L PRUDENCIO

Original Issue Date

05/06/2005

Effective Date

09/29/2025

Expiration Date

09/30/2027

City

MURPHYSBORO

State

Zip

62966

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

09/29/2025