BLAKELY PORTILLO Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070027490

License Status

ACTIVE

Business

First Name

BLAKELY

Last Name

PORTILLO

Business Name

BLAKELY PORTILLO

Original Issue Date

05/25/2023

Effective Date

08/01/2024

Expiration Date

09/30/2026

City

WYLIE

State

Zip

75098

Ever Disciplined

LastModifiedDate

08/01/2024