SCOTT HENRY BLOSTICA Podiatrist License verification

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016003685

License Status

INACTIVE

Business

First Name

SCOTT

Middle

HENRY

Last Name

BLOSTICA

Business Name

SCOTT HENRY BLOSTICA

Original Issue Date

06/22/1984

Effective Date

06/22/1984

Expiration Date

01/31/2001

City

ORLAND PARK

State

Zip

60462

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006