BAOTRAM DESERIE LU DPM - Podiatrist License in Illinois | # 135000616

BAOTRAM DESERIE LU DPM

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000616

License Status

EXPIRED

Business

N

First Name

BAOTRAM

Middle

DESERIE

Last Name

LU

Suffix

DPM

Business Name

BAOTRAM DESERIE LU DPM

Original Issue Date

06/22/2006

Effective Date

06/22/2006

Expiration Date

06/30/2007

State

IL

Ever Disciplined

N

LastModifiedDate

07/03/2007