RAYMOND ANGELO BRICKHOUSE DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****15

License Status

NOT RENEWED

Business

Title

DPM

First Name

RAYMOND

Middle

ANGELO

Last Name

BRICKHOUSE

Business Name

RAYMOND ANGELO BRICKHOUSE DPM

Original Issue Date

08/14/2008

Effective Date

01/21/2021

Expiration Date

01/31/2023

City

SAINT LOUIS

State

Zip

63117

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/31/2023