NEAL R MORTENSEN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016004706

License Status

NOT RENEWED

Business

First Name

NEAL R

Last Name

MORTENSEN

Business Name

NEAL R MORTENSEN

Original Issue Date

08/05/1994

Effective Date

08/05/1994

Expiration Date

01/31/2005

City

ORLAND PARK

State

Zip

60467

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006