KENZIE DARIAN WALDKOETTER DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135001243

License Status

ACTIVE

Business

Title

DPM

First Name

KENZIE

Middle

DARIAN

Last Name

WALDKOETTER

Business Name

KENZIE DARIAN WALDKOETTER DPM

Original Issue Date

07/09/2024

Effective Date

07/09/2024

Expiration Date

07/08/2027

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

06/28/2024