BAOTRAM DESERIE LU DPM Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000616

License Status

EXPIRED

Business

First Name

BAOTRAM

Middle

DESERIE

Last Name

Suffix

DPM

Business Name

BAOTRAM DESERIE LU DPM

Original Issue Date

06/22/2006

Effective Date

06/22/2006

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

07/03/2007