HEIDI FERMIN BONIFACIO Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070016111

License Status

NOT RENEWED

Business

First Name

HEIDI

Middle

FERMIN

Last Name

BONIFACIO

Business Name

HEIDI FERMIN BONIFACIO

Original Issue Date

11/16/2007

Effective Date

09/22/2008

Expiration Date

09/30/2010

City

JOPLIN

State

Zip

64801

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/08/2010