ROY HERMAN LIDTKE Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****22

License Status

NOT RENEWED

Business

First Name

ROY

Middle

HERMAN

Last Name

LIDTKE

Suffix

DPM DPM

Business Name

ROY HERMAN LIDTKE

Original Issue Date

03/17/1997

Effective Date

11/26/2008

Expiration Date

01/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/10/2011