THOMAS SCOTT NORDQUIST DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000856

License Status

CANCELLED

Business

Title

DPM

First Name

THOMAS

Middle

SCOTT

Last Name

NORDQUIST

Business Name

THOMAS SCOTT NORDQUIST DPM

Original Issue Date

06/25/2014

Effective Date

07/01/2016

Expiration Date

06/30/2017

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

06/15/2015