MATTHEW ALLEN POLK DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

ALLEN

Last Name

POLK

Suffix

DPM

Business Name

MATTHEW ALLEN POLK DPM

Original Issue Date

06/25/2008

Effective Date

12/05/2008

Expiration Date

01/31/2011

City

CHICAGO

State

Zip

60660

County

COOK

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/10/2011