NICHOLAS ALEKSEI PODKOWIROW DPM - Podiatrist License in Illinois | # 135000936

NICHOLAS ALEKSEI PODKOWIROW DPM

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000936

License Status

CANCELLED

Business

N

Title

DPM

First Name

NICHOLAS

Middle

ALEKSEI

Last Name

PODKOWIROW

Business Name

NICHOLAS ALEKSEI PODKOWIROW DPM

Original Issue Date

07/18/2016

Effective Date

07/01/2016

Expiration Date

07/01/2019

State

IL

Ever Disciplined

N

LastModifiedDate

07/18/2016