BROOKE KELLEY STOUGH DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****06

License Status

NOT RENEWED

Business

First Name

BROOKE

Middle

KELLEY

Last Name

STOUGH

Suffix

DPM

Business Name

BROOKE KELLEY STOUGH DPM

Original Issue Date

02/14/2011

Effective Date

02/14/2011

Expiration Date

01/31/2013

City

CHICAGO

State

Zip

60617

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/20/2013