MARY ELLEN ESTRADA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160004842

License Status

NOT RENEWED

Business

First Name

MARY

Middle

ELLEN

Last Name

ESTRADA

Business Name

MARY ELLEN ESTRADA

Original Issue Date

09/06/2007

Effective Date

09/18/2017

Expiration Date

09/30/2019

City

GENESEO

State

Zip

61254

County

HENRY

Ever Disciplined

LastModifiedDate

01/13/2020