BAOTRAM DESERIE LU DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005339

License Status

NOT RENEWED

Business

First Name

BAOTRAM

Middle

DESERIE

Last Name

Suffix

DPM

Business Name

BAOTRAM DESERIE LU DPM

Original Issue Date

07/10/2007

Effective Date

12/08/2008

Expiration Date

01/31/2011

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

03/10/2011