Idaho
Division of Occupational and Professional Licenses
Mrs. NICOLE LARUE LILYA
Physical Therapy Licensure Board - Physical Therapist Assistant
License number
PTA - 321
Date granted
08/13/2002
Date expires
10/16/2016
Class
Physical Therapy Licensure Board - Physical Therapist Assistant
Status
Current
Address
BLACKFOOT ID 83221
idaholicensing.com
ID 43734360
LAST UPDATED 2026-03-27 11:46:59 UTC
LAST UPDATED 2026-03-27 11:46:59 UTC
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