IDA WASHINGTON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036088370

License Status

NOT RENEWED

Business

First Name

IDA

Last Name

WASHINGTON

Suffix

Business Name

IDA WASHINGTON MD

Original Issue Date

05/03/1994

Effective Date

05/22/2008

Expiration Date

07/31/2011

City

MATTESON

State

Zip

60443

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011