JACQUELINE A INTRAVAIA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160009410

License Status

NOT RENEWED

Business

First Name

JACQUELINE

Middle

Last Name

INTRAVAIA

Business Name

JACQUELINE A INTRAVAIA

Original Issue Date

10/28/2021

Effective Date

07/07/2023

Expiration Date

09/30/2025

City

MARION

State

Zip

62959

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

12/30/2025