JACKIELYN SY BAUTISTA Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070022293

License Status

NOT RENEWED

Business

First Name

JACKIELYN

Middle

Last Name

BAUTISTA

Business Name

JACKIELYN SY BAUTISTA

Original Issue Date

08/04/2016

Effective Date

08/14/2018

Expiration Date

09/30/2020

City

BLUEFIELD

State

Zip

24701

Ever Disciplined

LastModifiedDate

01/14/2021