LYRA RIVERA PHAN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070009569

License Status

NOT RENEWED

Business

First Name

LYRA

Middle

RIVERA

Last Name

PHAN

Business Name

LYRA RIVERA PHAN

Original Issue Date

08/01/1996

Effective Date

08/27/2014

Expiration Date

09/30/2016

City

SAINT LOUIS

State

Zip

63146

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/26/2016