The holder whose full name is Lacanienta, Larry Mendoza,come from Bloomington IN,hold the Physical Therapist license(NO.05002937A) which status is Active.
| Name | Lacanienta, Larry Mendoza |
|---|---|
| License Number | 05002937A |
| License Type | Physical Therapist |
| License Status | Active |
| City | Bloomington |
| State | IN |