KRISTIN MARIE EIDE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139790

License Status

NOT RENEWED

Business

First Name

KRISTIN

Middle

MARIE

Last Name

EIDE

Suffix

Business Name

KRISTIN MARIE EIDE DO

Original Issue Date

02/18/2016

Effective Date

02/18/2016

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017