STEVEN THOMAS BRANTINGHAM DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000952

License Status

CANCELLED

Business

Title

DPM

First Name

STEVEN

Middle

THOMAS

Last Name

BRANTINGHAM

Business Name

STEVEN THOMAS BRANTINGHAM DPM

Original Issue Date

05/31/2017

Effective Date

07/01/2017

Expiration Date

07/01/2020

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

05/31/2017