ETINOSA ANN IDEMUDIA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125086201

License Status

ACTIVE

Business

Title

First Name

ETINOSA

Middle

ANN

Last Name

IDEMUDIA

Business Name

ETINOSA ANN IDEMUDIA MD

Original Issue Date

07/01/2025

Effective Date

07/01/2025

Expiration Date

06/30/2028

City

URBANA

State

Zip

61801

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

05/15/2025