MICHELLE EIDE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076664

License Status

EXPIRED

Business

Title

First Name

MICHELLE

Last Name

EIDE

Business Name

MICHELLE EIDE MD

Original Issue Date

06/26/2023

Effective Date

06/26/2023

Expiration Date

06/25/2024

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

10/30/2024