STEPHEN WAYNE DAUGHERTY DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000972

License Status

CANCELLED

Business

Title

DPM

First Name

STEPHEN

Middle

WAYNE

Last Name

DAUGHERTY

Business Name

STEPHEN WAYNE DAUGHERTY DPM

Original Issue Date

06/15/2017

Effective Date

06/15/2017

Expiration Date

06/15/2020

City

CHICAGO

State

Zip

60612

Ever Disciplined

LastModifiedDate

06/15/2017