ANDREA L PEACH DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****00

License Status

NOT RENEWED

Business

Title

DPM

First Name

ANDREA

Middle

Last Name

PEACH

Business Name

ANDREA L PEACH DPM

Original Issue Date

06/26/2008

Effective Date

12/10/2012

Expiration Date

01/31/2015

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/09/2015