ROSS WAYNE GREEN DPM - Podiatrist License in Illinois | # 135000726

ROSS WAYNE GREEN DPM

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000726

License Status

EXPIRED

Business

N

First Name

ROSS

Middle

WAYNE

Last Name

GREEN

Suffix

DPM

Business Name

ROSS WAYNE GREEN DPM

Original Issue Date

08/09/2010

Effective Date

08/09/2010

Expiration Date

08/09/2011

State

IL

Ever Disciplined

N

LastModifiedDate

09/30/2011