IRAKLY PATARAIA Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135001129

License Status

CANCELLED

Business

First Name

IRAKLY

Last Name

PATARAIA

Business Name

IRAKLY PATARAIA

Original Issue Date

06/10/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

06/10/2021