EDMOND F MERTZENICH Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****97

License Status

ACTIVE

Business

First Name

EDMOND F

Last Name

MERTZENICH

Business Name

EDMOND F MERTZENICH

Original Issue Date

03/28/1986

Effective Date

11/20/2024

Expiration Date

01/31/2027

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2025