Idaho
Division of Occupational and Professional Licenses
LARISSA WICKHAM
Physical Therapy Licensure Board - Physical Therapist Assistant
License number
PTA - 2570
Date granted
08/24/2009
Date expires
07/06/2017
Class
Physical Therapy Licensure Board - Physical Therapist Assistant
Status
Current
Address
TEMESCAL VALLEY CA 92883
idaholicensing.com
ID 43734801
LAST UPDATED 2024-02-05 13:24:31 UTC
LAST UPDATED 2024-02-05 13:24:31 UTC
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