BRENT ERIC VAN TIL DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005416

License Status

NOT RENEWED

Business

Title

DPM

First Name

BRENT

Middle

ERIC

Last Name

VAN TIL

Business Name

BRENT ERIC VAN TIL DPM

Original Issue Date

07/14/2009

Effective Date

12/23/2010

Expiration Date

01/31/2013

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Ever Disciplined

LastModifiedDate

03/20/2013