ANITA LYSTAD CABANILLA Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070000476

License Status

INACTIVE

Business

First Name

ANITA LYSTAD

Last Name

CABANILLA

Business Name

ANITA LYSTAD CABANILLA

Original Issue Date

11/15/1960

Effective Date

11/15/1960

Expiration Date

09/30/1984

City

ALBUQUERQUE

State

Zip

87106

County

NEW MEXICO

Ever Disciplined

LastModifiedDate

10/14/2005