JUSTIN KIDD GANDIA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

ACTIVE

Business

First Name

JUSTIN

Middle

KIDD

Last Name

GANDIA

Business Name

JUSTIN KIDD GANDIA

Original Issue Date

09/16/2002

Effective Date

04/26/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60615

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/26/2023