BRIAN P GRADISEK DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005597

License Status

NOT RENEWED

Business

Title

DPM

First Name

BRIAN

Middle

Last Name

GRADISEK

Business Name

BRIAN P GRADISEK DPM

Original Issue Date

02/13/2014

Effective Date

01/08/2015

Expiration Date

01/31/2017

City

DES PLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

03/27/2017