ESTIVEN ESTACIO Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160009904

License Status

ACTIVE

Business

First Name

ESTIVEN

Last Name

ESTACIO

Business Name

ESTIVEN ESTACIO

Original Issue Date

08/23/2023

Effective Date

07/02/2025

Expiration Date

09/30/2027

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

07/02/2025