JEFFREY PAUL BERTHOLD Orthotist, Prosthetist, and Pedorthist License verification

Business Entity

NOT RENEWED

License Type

Orthotist, Prosthetist, and Pedorthist

Description

LICENSED PROSTHETIST

License Number

211000239

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

PAUL

Last Name

BERTHOLD

Business Name

JEFFREY PAUL BERTHOLD

Original Issue Date

10/15/2009

Effective Date

10/15/2009

Expiration Date

09/30/2011

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

11/04/2011