BRIAN JOHN BURGESS DPM Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000678

License Status

EXPIRED

Business

Title

DPM

First Name

BRIAN

Middle

JOHN

Last Name

BURGESS

Business Name

BRIAN JOHN BURGESS DPM

Original Issue Date

06/16/2009

Effective Date

06/30/2010

Expiration Date

06/30/2011

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

07/19/2011