ANDREA S DIRKSEN Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000603

License Status

EXPIRED

Business

First Name

ANDREA

Middle

Last Name

DIRKSEN

Business Name

ANDREA S DIRKSEN

Original Issue Date

12/16/2005

Effective Date

12/16/2005

Expiration Date

06/30/2007

City

LOMBARD

State

Zip

60148

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/03/2007