BRECK M TIERNAN DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****52

License Status

NOT RENEWED

Business

First Name

BRECK

Middle

Last Name

TIERNAN

Suffix

DPM

Business Name

BRECK M TIERNAN DPM

Original Issue Date

06/06/2007

Effective Date

12/16/2008

Expiration Date

01/31/2011

City

CHICAGO

State

Zip

60641

County

COOK

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/10/2011