NICHOLAS C BRISSEY Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000893

License Status

EXPIRED

Business

First Name

NICHOLAS

Middle

Last Name

BRISSEY

Business Name

NICHOLAS C BRISSEY

Original Issue Date

06/30/2015

Effective Date

07/01/2016

Expiration Date

06/30/2018

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/04/2018