GRACIELA LATUPAN BAMBALAN Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070021437

License Status

INACTIVE

Business

First Name

GRACIELA

Middle

LATUPAN

Last Name

BAMBALAN

Business Name

GRACIELA LATUPAN BAMBALAN

Original Issue Date

07/21/2015

Effective Date

08/24/2020

Expiration Date

09/30/2022

City

CALIFON

State

Zip

07830

County

FLORIDA

Ever Disciplined

LastModifiedDate

06/30/2022