JONATHAN DUANE ROUSE Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****88

License Status

NOT RENEWED

Business

First Name

JONATHAN

Middle

DUANE

Last Name

ROUSE

Business Name

JONATHAN DUANE ROUSE

Original Issue Date

01/24/2019

Effective Date

01/24/2019

Expiration Date

01/31/2021

City

LAKE VILLA

State

Zip

60046

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2021