KAITLYN L WARD DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****25

License Status

NOT RENEWED

Business

Title

DPM

First Name

KAITLYN

Middle

Last Name

WARD

Business Name

KAITLYN L WARD DPM

Original Issue Date

08/01/2019

Effective Date

08/01/2019

Expiration Date

01/31/2021

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2021