TERRANCE J ROACH Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002508

License Status

NOT RENEWED

Business

First Name

TERRANCE J

Last Name

ROACH

Business Name

TERRANCE J ROACH

Original Issue Date

01/01/1998

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/25/2006