PHILIP GANES SIEBERT Podiatrist License verification

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****36

License Status

INACTIVE

Business

First Name

PHILIP GANES

Last Name

SIEBERT

Business Name

PHILIP GANES SIEBERT

Original Issue Date

09/18/1984

Effective Date

01/12/2021

Expiration Date

01/31/2023

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/02/2022