TYLER VAN BASTIAN DPT Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070026564

License Status

NOT RENEWED

Business

Title

DPT

First Name

TYLER

Last Name

VAN BASTIAN

Business Name

TYLER VAN BASTIAN DPT

Original Issue Date

05/04/2022

Effective Date

05/04/2022

Expiration Date

09/30/2022

City

RIO RANCHO

State

Zip

87144

Ever Disciplined

LastModifiedDate

11/28/2022