MALCOLM D HERZOG DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****43

License Status

ACTIVE

Business

First Name

MALCOLM

Middle

Last Name

HERZOG

Suffix

DPM

Business Name

MALCOLM D HERZOG DPM

Original Issue Date

06/30/1981

Effective Date

12/18/2024

Expiration Date

01/31/2027

City

CHICAGO

State

Zip

60632

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/18/2024