NINO IDOIDZE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

ACTIVE

Business

Title

First Name

NINO

Last Name

IDOIDZE

Business Name

NINO IDOIDZE MD

Original Issue Date

01/06/2021

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023