TEDD BRUCE MASIONGALE Speech-Language Pathologist License verification

Business Entity

ACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146012884

License Status

ACTIVE

Business

First Name

TEDD

Middle

BRUCE

Last Name

MASIONGALE

Business Name

TEDD BRUCE MASIONGALE

Original Issue Date

08/18/2015

Effective Date

08/16/2025

Expiration Date

10/31/2027

City

IMPERIAL

State

Zip

63052

Ever Disciplined

LastModifiedDate

08/16/2025