TODD L DIVAN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****75

License Status

NOT RENEWED

Business

First Name

TODD

Middle

Last Name

DIVAN

Business Name

TODD L DIVAN

Original Issue Date

01/30/1996

Effective Date

09/05/2012

Expiration Date

01/31/2013

City

DANVILLE

State

Zip

61832

County

VERMILION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/20/2013