KATHERINE A WIDERBORG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

KATHERINE A

Last Name

WIDERBORG

Suffix

Business Name

KATHERINE A WIDERBORG MD

Original Issue Date

06/30/1995

Effective Date

06/24/2008

Expiration Date

07/31/2011

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

04/05/2020