TARA SUZANNE FOX DPM Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000505

License Status

EXPIRED

Business

First Name

TARA

Middle

SUZANNE

Last Name

FOX

Suffix

DPM

Business Name

TARA SUZANNE FOX DPM

Original Issue Date

06/19/2002

Effective Date

06/19/2002

Expiration Date

06/30/2004

City

DES PLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

09/25/2006