ANDREW J ZIDOW MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062120

License Status

CANCELLED

Business

Title

First Name

ANDREW

Middle

Last Name

ZIDOW

Business Name

ANDREW J ZIDOW MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

PERU

State

Zip

61354

County

LA SALLE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014