KRISTIN MARIE EIDE DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062951

License Status

CANCELLED

Business

First Name

KRISTIN

Middle

MARIE

Last Name

EIDE

Suffix

Business Name

KRISTIN MARIE EIDE DO

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014