ROY HERMAN LIDTKE Orthotist, Prosthetist, and Pedorthist License verification

Business Entity

INACTIVE

License Type

Orthotist, Prosthetist, and Pedorthist

Description

LICENSED PEDORTHIST

License Number

212000101

License Status

INACTIVE

Business

First Name

ROY

Middle

HERMAN

Last Name

LIDTKE

Suffix

DPM DPM

Business Name

ROY HERMAN LIDTKE

Original Issue Date

02/26/2002

Effective Date

02/26/2002

Expiration Date

09/30/2005

City

ELBERON

State

Zip

52225

County

IOWA

Ever Disciplined

LastModifiedDate

05/30/2006