KRISTIN MARIE EIDE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

KRISTIN

Middle

MARIE

Last Name

EIDE

Suffix

Business Name

KRISTIN MARIE EIDE DO

Original Issue Date

02/18/2016

Effective Date

02/18/2016

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017