KYLE DEAN SWANSON DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000913

License Status

CANCELLED

Business

Title

DPM

First Name

KYLE

Middle

DEAN

Last Name

SWANSON

Business Name

KYLE DEAN SWANSON DPM

Original Issue Date

06/07/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

06/07/2016