Connecticut
Department of Consumer Protection
GEORGIANNA FORMAN TATA
Physical Therapist
License number
6595
Date granted
05/01/2014
Date expires
04/30/2015
Class
Physical Therapist
Status
Active
Address
219 MATTHEW STREET, Prospect, CT, 06712
ctlicensing.org
ID 4299028
LAST UPDATED 2024-05-01 06:46:31 UTC
LAST UPDATED 2024-05-01 06:46:31 UTC
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