BLAIR RYAN HENDERSHOT DPM Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000929

License Status

EXPIRED

Business

Title

DPM

First Name

BLAIR

Middle

RYAN

Last Name

HENDERSHOT

Business Name

BLAIR RYAN HENDERSHOT DPM

Original Issue Date

06/22/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

10/02/2019