ERIC WALTON WIDEMAN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045679

License Status

EXPIRED

Business

First Name

ERIC

Middle

WALTON

Last Name

WIDEMAN

Suffix

Business Name

ERIC WALTON WIDEMAN DO

Original Issue Date

04/28/2003

Effective Date

04/28/2003

Expiration Date

06/18/2004

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Rotating Internship

Ever Disciplined

LastModifiedDate

09/22/2006