RONALD L BANTA Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002546

License Status

NOT RENEWED

Business

First Name

RONALD L

Last Name

BANTA

Business Name

RONALD L BANTA

Original Issue Date

07/25/1968

Effective Date

07/25/1968

City

INDIANAPOLIS

State

Zip

46240

County

INDIANA

Ever Disciplined

LastModifiedDate

09/25/2006