BRIAN P GRADISEK DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

Title

DPM

First Name

BRIAN

Middle

Last Name

GRADISEK

Business Name

BRIAN P GRADISEK DPM

Original Issue Date

03/25/2014

Effective Date

01/08/2015

Expiration Date

01/31/2017

City

DES PLAINES

State

Zip

60016

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/27/2017