DYLAN K LASTA - Physical Therapist License in Illinois | # 160006475

DYLAN K LASTA

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006475

License Status

NOT RENEWED

Business

N

First Name

DYLAN

Middle

K

Last Name

LASTA

Business Name

DYLAN K LASTA

Original Issue Date

08/05/2013

Effective Date

09/24/2019

Expiration Date

01/31/2022

State

IL

Ever Disciplined

N

LastModifiedDate

05/19/2022