BROCK ANDREW SWANSON Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****43

License Status

NOT RENEWED

Business

First Name

BROCK

Middle

ANDREW

Last Name

SWANSON

Business Name

BROCK ANDREW SWANSON

Original Issue Date

08/12/2015

Effective Date

12/10/2018

Expiration Date

01/31/2021

City

CHICAGO

State

Zip

60607

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2021