JULIE THOMAS KIDANGAN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057653

License Status

CANCELLED

Business

Title

First Name

JULIE

Middle

THOMAS

Last Name

KIDANGAN

Business Name

JULIE THOMAS KIDANGAN DO

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

LAGRANGE

State

Zip

60525

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/11/2010