EDWARD T BERNBOM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****30

License Status

NOT RENEWED

Business

First Name

EDWARD T

Last Name

BERNBOM

Business Name

EDWARD T BERNBOM

Original Issue Date

01/01/1998

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