JACK ANTHONY KOCH Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016003005

License Status

NOT RENEWED

Business

First Name

JACK ANTHONY

Last Name

KOCH

Business Name

JACK ANTHONY KOCH

Original Issue Date

06/28/1978

Effective Date

06/28/1978

City

CHICAGO

State

Zip

60630

County

COOK

Ever Disciplined

LastModifiedDate

09/25/2006