DAVID T THOM DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****74

License Status

ACTIVE

Business

Title

DPM

First Name

DAVID

Middle

Last Name

THOM

Prefix

Business Name

DAVID T THOM DPM

Original Issue Date

05/20/2024

Effective Date

12/03/2024

Expiration Date

01/31/2027

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2024