TINA RENEE ENTWISTLE DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005194

License Status

ACTIVE

Business

First Name

TINA

Middle

RENEE

Last Name

ENTWISTLE

Suffix

DPM

Business Name

TINA RENEE ENTWISTLE DPM

Original Issue Date

06/30/2004

Effective Date

01/29/2025

Expiration Date

01/31/2027

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/26/2025