JAYDIENNE PAULISA C FONTEJON DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135001123

License Status

CANCELLED

Business

Title

DPM

First Name

JAYDIENNE PAULISA

Middle

Last Name

FONTEJON

Business Name

JAYDIENNE PAULISA C FONTEJON DPM

Original Issue Date

06/07/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

LOMBARD

State

Zip

60148

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/25/2021