BRECK M TIERNAN DPM Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000583

License Status

EXPIRED

Business

First Name

BRECK

Middle

Last Name

TIERNAN

Suffix

DPM

Business Name

BRECK M TIERNAN DPM

Original Issue Date

06/17/2005

Effective Date

06/17/2005

Expiration Date

07/01/2007

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

07/03/2007