License holder summary

EVAN TIRTAPUTRA is a Physical Therapy Licensure Board - Physical Therapist licensed to practice in Idaho. The address on file for EVAN TIRTAPUTRA is SAN GABRIEL CA 91775. This licensed professional license is not current. The license was granted 02/09/2015 and expired on 07/31/2016.

Idaho

Division of Occupational and Professional Licenses

EVAN TIRTAPUTRA
Physical Therapy Licensure Board - Physical Therapist
License number
PT - 3844
Date granted
02/09/2015
Date expires
07/31/2016
Class
Physical Therapy Licensure Board - Physical Therapist
Status
Not Current
Address
SAN GABRIEL CA 91775
idaholicensing.com
ID 43733368
LAST UPDATED 2024-03-23 11:02:54 UTC

This website is unaffiliated with the Division of Occupational and Professional Licenses. Please verify all information directly with the relevant official government authority.

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