GARRY DEAN WEIDE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036134829

License Status

NOT RENEWED

Business

Title

First Name

GARRY

Middle

DEAN

Last Name

WEIDE

Business Name

GARRY DEAN WEIDE DO

Original Issue Date

03/20/2014

Effective Date

05/12/2014

Expiration Date

07/31/2017

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/01/2017