OTHA BRISCO Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002280

License Status

NOT RENEWED

Business

First Name

OTHA

Last Name

BRISCO

Business Name

OTHA BRISCO

Original Issue Date

02/02/1956

Effective Date

02/01/2007

Expiration Date

01/31/2009

City

CHICAGO

State

Zip

60620

County

COOK

Ever Disciplined

LastModifiedDate

03/17/2009