KURT S GUSTAVSON Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****32

License Status

NOT RENEWED

Business

First Name

KURT S

Last Name

GUSTAVSON

Business Name

KURT S GUSTAVSON

Original Issue Date

08/22/1985

Effective Date

08/22/1985

Expiration Date

01/31/1989

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006