ANDREA S DIRKSEN - Podiatrist License in Wisconsin | # 31*****16

ANDREA S DIRKSEN

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****16

License Status

NOT RENEWED

Business

N

First Name

ANDREA

Middle

S

Last Name

DIRKSEN

Business Name

ANDREA S DIRKSEN

Original Issue Date

08/25/2008

Effective Date

01/25/2017

Expiration Date

01/31/2019

State

WI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

03/28/2019