GREGORY W BOAKE DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****03

License Status

NOT RENEWED

Business

First Name

GREGORY W

Last Name

BOAKE

Suffix

DPM

Business Name

GREGORY W BOAKE DPM

Original Issue Date

10/29/2002

Effective Date

10/29/2002

Expiration Date

01/31/2007

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/16/2007