AUGUSTIN DE ASIS BANAYLO JR Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070010953

License Status

NOT RENEWED

Business

First Name

AUGUSTIN

Middle

DE ASIS

Last Name

BANAYLO

Suffix

Business Name

AUGUSTIN DE ASIS BANAYLO JR

Original Issue Date

10/29/1998

Effective Date

10/29/1998

Expiration Date

09/30/2000

City

JACKSON

State

Zip

49202

County

MICHIGAN

Ever Disciplined

LastModifiedDate

10/17/2005