BRUCE A CARLSON Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002565

License Status

NOT RENEWED

Business

First Name

BRUCE A

Last Name

CARLSON

Business Name

BRUCE A CARLSON

Original Issue Date

08/04/1969

Effective Date

08/04/1969

Expiration Date

01/31/2003

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006