GREGORY LEE PENFOLD Orthotist, Prosthetist, and Pedorthist License verification

Business Entity

NOT RENEWED

License Type

Orthotist, Prosthetist, and Pedorthist

Description

LICENSED ORTHOTIST

License Number

213000296

License Status

NOT RENEWED

Business

First Name

GREGORY

Middle

LEE

Last Name

PENFOLD

Business Name

GREGORY LEE PENFOLD

Original Issue Date

08/08/2012

Effective Date

08/08/2012

Expiration Date

09/30/2013

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/12/2013