STEPHEN WAYNE DAUGHERTY DPM - Podiatrist License in Illinois | # 135000972

STEPHEN WAYNE DAUGHERTY DPM

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000972

License Status

CANCELLED

Business

N

Title

DPM

First Name

STEPHEN

Middle

WAYNE

Last Name

DAUGHERTY

Business Name

STEPHEN WAYNE DAUGHERTY DPM

Original Issue Date

06/15/2017

Effective Date

06/15/2017

Expiration Date

06/15/2020

State

IL

Ever Disciplined

N

LastModifiedDate

06/15/2017