ROUSSEL LAGURA TABANERA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160006507

License Status

NOT RENEWED

Business

First Name

ROUSSEL

Middle

LAGURA

Last Name

TABANERA

Business Name

ROUSSEL LAGURA TABANERA

Original Issue Date

08/07/2013

Effective Date

08/10/2015

Expiration Date

09/30/2017

City

POPLAR BLUFF

State

Zip

63901

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/01/2017