OTHA BRISCO - Podiatrist License in Illinois | # 016002280

OTHA BRISCO

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002280

License Status

NOT RENEWED

Business

N

First Name

OTHA

Last Name

BRISCO

Business Name

OTHA BRISCO

Original Issue Date

02/02/1956

Effective Date

02/01/2007

Expiration Date

01/31/2009

State

IL

Ever Disciplined

N

LastModifiedDate

03/17/2009