JEFFREY PAUL BERTHOLD - Orthotist, Prosthetist, and Pedorthist License in Illinois | # 211000239

JEFFREY PAUL BERTHOLD

Business Entity

NOT RENEWED

License Type

Orthotist, Prosthetist, and Pedorthist

Description

LICENSED PROSTHETIST

License Number

211000239

License Status

NOT RENEWED

Business

N

First Name

JEFFREY

Middle

PAUL

Last Name

BERTHOLD

Business Name

JEFFREY PAUL BERTHOLD

Original Issue Date

10/15/2009

Effective Date

10/15/2009

Expiration Date

09/30/2011

State

IL

Ever Disciplined

N

LastModifiedDate

11/04/2011