LUIS A NIDEA MD - Medical Doctor License in Indiana | # 33*****28

LUIS A NIDEA MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

N

Title

MD

First Name

LUIS

Middle

A

Last Name

NIDEA

Business Name

LUIS A NIDEA MD

Original Issue Date

01/26/1987

Effective Date

01/26/1987

Expiration Date

07/31/2005

State

IN

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

04/05/2020