ERIC ANTHONY WIDRA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

Title

First Name

ERIC

Middle

ANTHONY

Last Name

WIDRA

Business Name

ERIC ANTHONY WIDRA MD

Original Issue Date

12/31/2015

Effective Date

12/31/2015

Expiration Date

07/31/2017

City

WASHINGTON

State

Zip

20016

County

DISTRICT OF COLUMBIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017