MARY GRACE VILELA CAPISTRANO Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070022721

License Status

NOT RENEWED

Business

First Name

MARY GRACE

Middle

VILELA

Last Name

CAPISTRANO

Business Name

MARY GRACE VILELA CAPISTRANO

Original Issue Date

11/29/2016

Effective Date

09/19/2018

Expiration Date

09/30/2020

City

BROOKLYN

State

Zip

11218

County

NEW YORK

Ever Disciplined

LastModifiedDate

01/14/2021