RAQUEL B VANDER WAL Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160007733

License Status

NOT RENEWED

Business

First Name

RAQUEL

Middle

Last Name

VANDER WAL

Business Name

RAQUEL B VANDER WAL

Original Issue Date

11/02/2016

Effective Date

12/21/2021

Expiration Date

09/30/2023

City

TRAVELERS REST

State

Zip

29690

Ever Disciplined

LastModifiedDate

02/02/2024