DUSTIN R RIDOUT Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033319

License Status

EXPIRED

Business

First Name

DUSTIN

Middle

Last Name

RIDOUT

Business Name

DUSTIN R RIDOUT

Original Issue Date

06/12/1995

Effective Date

06/12/1995

Expiration Date

06/30/2001

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

09/22/2006