TODD G LEWIS DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****99

License Status

NOT RENEWED

Business

First Name

TODD

Middle

Last Name

LEWIS

Suffix

DPM

Business Name

TODD G LEWIS DPM

Original Issue Date

09/18/2012

Effective Date

01/20/2015

Expiration Date

01/31/2017

City

CHICAGO

State

Zip

60634

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/27/2017