RITA VIDA ODEGAARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

First Name

RITA

Middle

VIDA

Last Name

ODEGAARD

Suffix

Business Name

RITA VIDA ODEGAARD MD

Original Issue Date

11/23/1998

Effective Date

07/30/2014

Expiration Date

07/31/2017

City

SAINT CHARLES

State

Zip

60174

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017