CHRISTY L WIARDA DPM Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000729

License Status

EXPIRED

Business

Title

DPM

First Name

CHRISTY

Middle

Last Name

WIARDA

Business Name

CHRISTY L WIARDA DPM

Original Issue Date

09/29/2010

Effective Date

09/29/2010

Expiration Date

06/20/2011

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Ever Disciplined

LastModifiedDate

07/07/2011