DIANA T WIDICUS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036062017

License Status

ACTIVE

Business

First Name

DIANA T

Last Name

WIDICUS

Suffix

Business Name

DIANA T WIDICUS MD

Original Issue Date

04/16/1981

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/14/2023