BRIAN LEE MARTIN DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005263

License Status

NOT RENEWED

Business

Title

DPM

First Name

BRIAN

Middle

LEE

Last Name

MARTIN

Business Name

BRIAN LEE MARTIN DPM

Original Issue Date

10/11/2005

Effective Date

12/02/2014

Expiration Date

01/31/2017

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

03/27/2017