KATHLEEN E WIDES Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036068567

License Status

NOT RENEWED

Business

First Name

KATHLEEN E

Last Name

WIDES

Business Name

KATHLEEN E WIDES

Original Issue Date

04/25/1984

Effective Date

04/25/1984

Expiration Date

07/31/2005

City

BELLVILLE

State

Zip

62223

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/09/2006