MARK ROBERT WAVRUNEK DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005840

License Status

ACTIVE

Business

Title

DPM

First Name

MARK

Middle

ROBERT

Last Name

WAVRUNEK

Business Name

MARK ROBERT WAVRUNEK DPM

Original Issue Date

05/31/2019

Effective Date

11/02/2024

Expiration Date

01/31/2027

City

QUINCY

State

Zip

62305

County

ADAMS

Ever Disciplined

LastModifiedDate

11/02/2024