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Lisa
Lisa
Penta
Physical therapist assistant
Waycross, United States
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Florida Health Care Practitioner Data Portal
Full name
LISA PENTA
Job Title
Physical Therapist Assistant
Location
Waycross, GA, USA
LIC ID
6146
Current License Expiration Date
30/11/2025
Original Date
02/07/2001
Professional Rank Code
PTA
Effective Date
02/07/2001
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
Out of State
Practice Location Address Line 1
606 Gilmore Street
Practice Location Address City
WAYCROSS
Practice Location Address State
GA
Practice Location Address Zipcode
31501
Prescribing Indicator
N
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