JESSE JAMES EWALDT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080279

License Status

EXPIRED

Business

Title

First Name

JESSE

Middle

JAMES

Last Name

EWALDT

Business Name

JESSE JAMES EWALDT MD

Original Issue Date

06/26/2022

Effective Date

06/26/2022

Expiration Date

06/25/2025

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

11/03/2025