CHRISTOPHER JORDAN MIEDEMA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064907

License Status

EXPIRED

Business

Title

First Name

CHRISTOPHER

Middle

JORDAN

Last Name

MIEDEMA

Business Name

CHRISTOPHER JORDAN MIEDEMA MD

Original Issue Date

06/26/2014

Effective Date

06/26/2014

Expiration Date

06/25/2017

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/19/2017