MICHAEL KRISTIAN EIDE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

KRISTIAN

Last Name

EIDE

Suffix

Business Name

MICHAEL KRISTIAN EIDE MD

Original Issue Date

11/06/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

11/10/2011