STEPHEN WAYNE DAUGHERTY DPM - Podiatrist License in Illinois | # 016005798

STEPHEN WAYNE DAUGHERTY DPM

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005798

License Status

NOT RENEWED

Business

N

Title

DPM

First Name

STEPHEN

Middle

WAYNE

Last Name

DAUGHERTY

Business Name

STEPHEN WAYNE DAUGHERTY DPM

Original Issue Date

07/06/2018

Effective Date

01/14/2019

Expiration Date

01/31/2021

State

IL

Ever Disciplined

N

LastModifiedDate

03/11/2021