TRAVIS S JENSEN DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****94

License Status

NOT RENEWED

Business

First Name

TRAVIS

Middle

Last Name

JENSEN

Suffix

DPM

Business Name

TRAVIS S JENSEN DPM

Original Issue Date

04/27/2004

Effective Date

11/21/2006

Expiration Date

01/31/2009

City

CHICAGO

State

Zip

60610

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/17/2009