KIRK W NEUSTROM DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****29

License Status

NOT RENEWED

Business

First Name

KIRK W

Last Name

NEUSTROM

Suffix

DPM

Business Name

KIRK W NEUSTROM DPM

Original Issue Date

08/22/1986

Effective Date

08/22/1986

Expiration Date

01/31/1993

City

CHICAGO

State

Zip

60610

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006