Idaho
Division of Occupational and Professional Licenses
MS. SIMONE RACHELLE MATA
Physical Therapy Licensure Board - Physical Therapist
License number
PT - 4523
Date granted
05/18/2016
Date expires
03/20/2018
Class
Physical Therapy Licensure Board - Physical Therapist
Status
Current
Address
SALT LAKE CITY UT 84106
idaholicensing.com
ID 43732214
LAST UPDATED 2024-02-16 15:17:03 UTC
LAST UPDATED 2024-02-16 15:17:03 UTC
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