KATHERINE A WIDERBORG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

ACTIVE

Business

First Name

KATHERINE A

Last Name

WIDERBORG

Suffix

Business Name

KATHERINE A WIDERBORG MD

Original Issue Date

08/30/1984

Effective Date

07/08/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/08/2023