LAWRENCE A SHORT Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016003095

License Status

NOT RENEWED

Business

First Name

LAWRENCE A

Last Name

SHORT

Business Name

LAWRENCE A SHORT

Original Issue Date

06/27/1979

Effective Date

01/05/2021

Expiration Date

01/31/2023

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

03/31/2023