ELLEN M MIDDENDORF Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108143

License Status

ACTIVE

Business

First Name

ELLEN

Middle

Last Name

MIDDENDORF

Business Name

ELLEN M MIDDENDORF

Original Issue Date

11/12/2002

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

WATERLOO

State

Zip

62298

County

MONROE

Ever Disciplined

LastModifiedDate

04/06/2023