KIRK D BROCK Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****98

License Status

NOT RENEWED

Business

First Name

KIRK D

Last Name

BROCK

Business Name

KIRK D BROCK

Original Issue Date

07/01/1992

Effective Date

07/01/1992

Expiration Date

01/31/1993

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006