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| License Type: | Physical Therapist |
| License: | PT331 |
| First Name: | Wayne |
| Middle Name: | P |
| Last Name: | Jimenez |
| Original Issue Date: | 1/31/1980 |
| Expiration Date: | 6/30/2027 |
| Status: | ACTIVE |
| Disciplinary Action: | None |
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