SUPNA O REILLY DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****37

License Status

ACTIVE

Business

First Name

SUPNA

Middle

Last Name

REILLY

Suffix

DPM

Business Name

SUPNA O REILLY DPM

Original Issue Date

07/06/2011

Effective Date

12/23/2024

Expiration Date

01/31/2027

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2025