CHRISTY L WIARDA DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****28

License Status

NOT RENEWED

Business

Title

DPM

First Name

CHRISTY

Middle

Last Name

WIARDA

Business Name

CHRISTY L WIARDA DPM

Original Issue Date

06/21/2011

Effective Date

01/14/2013

Expiration Date

01/31/2015

City

MCHENRY

State

Zip

60051

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/09/2015