DALE S BRINK DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

DALE S

Last Name

BRINK

Suffix

DPM

Business Name

DALE S BRINK DPM

Original Issue Date

10/17/1995

Effective Date

12/02/2008

Expiration Date

01/31/2011

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/10/2011