JEFFREY A KIDD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

CANCELLED

Business

First Name

JEFFREY A

Last Name

KIDD

Business Name

JEFFREY A KIDD

Original Issue Date

04/28/1995

Effective Date

10/15/2008

Expiration Date

07/31/2011

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011