OTHA BRISCO Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****68

License Status

NOT RENEWED

Business

First Name

OTHA

Last Name

BRISCO

Business Name

OTHA BRISCO

Original Issue Date

01/01/1998

Expiration Date

01/31/1995

City

CHICAGO

State

Zip

60607

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006