STEVEN THOMAS BRANTINGHAM DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****80

License Status

NOT RENEWED

Business

Title

DPM

First Name

STEVEN

Middle

THOMAS

Last Name

BRANTINGHAM

Business Name

STEVEN THOMAS BRANTINGHAM DPM

Original Issue Date

09/21/2018

Effective Date

12/27/2018

Expiration Date

01/31/2021

City

DIXON

State

Zip

61021

County

LEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2021