LORA KOSIVZOFF DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016004167

License Status

ACTIVE

Business

First Name

LORA

Last Name

KOSIVZOFF

Suffix

DPM

Business Name

LORA KOSIVZOFF DPM

Original Issue Date

08/15/1987

Effective Date

01/30/2025

Expiration Date

01/31/2027

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

02/26/2025