License Number: MA79473

Data As Of 3/1/2024

Profession Massage Therapist
License MA79473
License Status REVOKED/
License Expiration Date 8/31/2023
License Original Issue Date 07/24/2015
Address of Record If further information is needed, please contact the Department of Health at (850) 488-0595.
Discipline on File Yes
Public Complaint Yes

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