BRENT ERIC VAN TIL DPM - Podiatrist License in Illinois | # 135000668

BRENT ERIC VAN TIL DPM

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000668

License Status

EXPIRED

Business

N

Title

DPM

First Name

BRENT

Middle

ERIC

Last Name

VAN TIL

Business Name

BRENT ERIC VAN TIL DPM

Original Issue Date

07/28/2008

Effective Date

07/01/2008

Expiration Date

06/30/2009

State

IL

Ever Disciplined

N

LastModifiedDate

07/01/2009