CLYDE GLENN GORDON DOROMAL Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070015534

License Status

ACTIVE

Business

First Name

CLYDE GLENN

Middle

GORDON

Last Name

DOROMAL

Business Name

CLYDE GLENN GORDON DOROMAL

Original Issue Date

01/18/2007

Effective Date

09/23/2024

Expiration Date

09/30/2026

City

FARMINGTON

State

Zip

63640

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/23/2024