CHRISTY L WIARDA DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005486

License Status

NOT RENEWED

Business

Title

DPM

First Name

CHRISTY

Middle

Last Name

WIARDA

Business Name

CHRISTY L WIARDA DPM

Original Issue Date

06/17/2011

Effective Date

01/14/2013

Expiration Date

01/31/2015

City

MCHENRY

State

Zip

60051

County

MCHENRY

Ever Disciplined

LastModifiedDate

03/09/2015