DALE ALAN DOORNBOS DC - Orthotist, Prosthetist, and Pedorthist License in Illinois | # 212000147

DALE ALAN DOORNBOS DC

Business Entity

INACTIVE

License Type

Orthotist, Prosthetist, and Pedorthist

Description

LICENSED PEDORTHIST

License Number

212000147

License Status

INACTIVE

Business

N

Title

DC

First Name

DALE

Middle

ALAN

Last Name

DOORNBOS

Business Name

DALE ALAN DOORNBOS DC

Original Issue Date

10/02/2007

Effective Date

10/02/2007

Expiration Date

09/30/2009

State

IL

Ever Disciplined

N

LastModifiedDate

09/04/2009