OMAR FONSECA Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160009394

License Status

ACTIVE

Business

First Name

OMAR

Last Name

FONSECA

Business Name

OMAR FONSECA

Original Issue Date

09/13/2021

Effective Date

08/25/2025

Expiration Date

09/30/2027

City

GENOA CITY

State

Zip

53128

Ever Disciplined

LastModifiedDate

08/25/2025