GUY A LAVINE DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****04

License Status

NOT RENEWED

Business

First Name

GUY

Middle

Last Name

LAVINE

Suffix

DPM

Business Name

GUY A LAVINE DPM

Original Issue Date

11/22/1996

Effective Date

12/13/2006

Expiration Date

01/31/2009

City

SOUTH CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/17/2009