Indiana
Professional Licensing Agency
EDWIN REQUILLO CAPUYAN
Physical Therapist
License number
05004058A
Date granted
08/22/1994
Date expires
06/30/2016
Class
Physical Therapist
Status
Active
Address
Fort Wayne IN 46835
indianalicensing.org
ID 8371473
LAST UPDATED 2024-05-08 13:13:25 UTC
LAST UPDATED 2024-05-08 13:13:25 UTC
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