DYLAN K LASTA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006475

License Status

NOT RENEWED

Business

First Name

DYLAN

Middle

Last Name

LASTA

Business Name

DYLAN K LASTA

Original Issue Date

08/05/2013

Effective Date

09/24/2019

Expiration Date

01/31/2022

City

ROSELLE

State

Zip

60172

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/19/2022