TIPHANI VONTRAI JAMES DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000930

License Status

CANCELLED

Business

Title

DPM

First Name

TIPHANI

Middle

VONTRAI

Last Name

JAMES

Business Name

TIPHANI VONTRAI JAMES DPM

Original Issue Date

06/23/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/20/2016