DAVID FREDERICK WIDITZ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

ACTIVE

Business

Title

First Name

DAVID

Middle

FREDERICK

Last Name

WIDITZ

Business Name

DAVID FREDERICK WIDITZ MD

Original Issue Date

09/22/2023

Effective Date

09/22/2023

Expiration Date

07/31/2026

City

DANVILLE

State

Zip

61832

County

VERMILION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/22/2023