TODD L DIVAN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016004761

License Status

NOT RENEWED

Business

First Name

TODD

Middle

Last Name

DIVAN

Business Name

TODD L DIVAN

Original Issue Date

12/07/1995

Effective Date

09/05/2012

Expiration Date

01/31/2013

City

POTOMAC

State

Zip

61865

County

VERMILION

Ever Disciplined

LastModifiedDate

03/20/2013