THOMAS D HEIDEWALD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

First Name

THOMAS D

Last Name

HEIDEWALD

Suffix

Business Name

THOMAS D HEIDEWALD MD

Original Issue Date

01/20/1994

Effective Date

01/20/1994

Expiration Date

07/31/1999

City

ALGONQUIN

State

Zip

60102

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006