DALE ALAN DOORNBOS DC Orthotist, Prosthetist, and Pedorthist License verification

Business Entity

INACTIVE

License Type

Orthotist, Prosthetist, and Pedorthist

Description

LICENSED PEDORTHIST

License Number

212000147

License Status

INACTIVE

Business

Title

First Name

DALE

Middle

ALAN

Last Name

DOORNBOS

Business Name

DALE ALAN DOORNBOS DC

Original Issue Date

10/02/2007

Effective Date

10/02/2007

Expiration Date

09/30/2009

City

NEW LENOX

State

Zip

60451

County

WILL

Ever Disciplined

LastModifiedDate

09/04/2009