GLEN JAY SIDLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

GLEN JAY

Last Name

SIDLER

Suffix

Business Name

GLEN JAY SIDLER MD

Original Issue Date

01/01/1997

Effective Date

05/08/2017

Expiration Date

09/30/2020

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021