TARA SUZANNE FOX DPM - Podiatrist License in Illinois | # 135000505

TARA SUZANNE FOX DPM

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000505

License Status

EXPIRED

Business

N

First Name

TARA

Middle

SUZANNE

Last Name

FOX

Suffix

DPM

Business Name

TARA SUZANNE FOX DPM

Original Issue Date

06/19/2002

Effective Date

06/19/2002

Expiration Date

06/30/2004

State

IL

Ever Disciplined

N

LastModifiedDate

09/25/2006