SUPNA O REILLY DPM Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000716

License Status

EXPIRED

Business

First Name

SUPNA

Middle

Last Name

REILLY

Suffix

DPM

Business Name

SUPNA O REILLY DPM

Original Issue Date

07/06/2010

Effective Date

07/01/2010

Expiration Date

06/30/2011

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

07/19/2011