DAVID FREDERICK WIDITZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000266

License Status

EXPIRED

Business

Title

First Name

DAVID

Middle

FREDERICK

Last Name

WIDITZ

Business Name

DAVID FREDERICK WIDITZ MD

Original Issue Date

06/01/2006

Effective Date

06/01/2006

Expiration Date

06/30/2006

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/25/2006