MATTHEW LEE DEBOLT Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006337

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

LEE

Last Name

DEBOLT

Business Name

MATTHEW LEE DEBOLT

Original Issue Date

02/05/2013

Effective Date

08/24/2017

Expiration Date

09/30/2019

City

ROANOKE

State

Zip

46783

County

INDIANA

Ever Disciplined

LastModifiedDate

01/13/2020