Evan D Short
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License Status Legend
Current Date and Time
03/31/2023 03:28:03 MST
Street
2919 S Ellsworth Rd Suite 102
City
Mesa
State
AZ
Zip Code
85212-2164
Phone 4802293082
Board Arizona State Board of Physical Therapy
License Number
LPT-011733
License Type
Physical Therapist
Prescribing Authority Number
Issue Date
08/04/2015
Expiration Date
08/31/2024
Discipline
E-LICENSING
