DANIEL POBLETE TAN Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070017578

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

POBLETE

Last Name

TAN

Business Name

DANIEL POBLETE TAN

Original Issue Date

01/11/2010

Effective Date

09/22/2014

Expiration Date

09/30/2016

City

JERSEY CITY

State

Zip

07302

County

NEW JERSEY

Ever Disciplined

LastModifiedDate

11/26/2016