MARA A BALLESTEROS Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070008479

License Status

NOT RENEWED

Business

First Name

MARA A

Last Name

BALLESTEROS

Business Name

MARA A BALLESTEROS

Original Issue Date

12/14/1994

Effective Date

12/14/1994

Expiration Date

09/30/2000

City

BATON ROUGE

State

Zip

70816

County

LOUISIANA

Ever Disciplined

LastModifiedDate

10/17/2005