JEFFREY A KIDD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

JEFFREY A

Last Name

KIDD

Business Name

JEFFREY A KIDD

Original Issue Date

04/28/2000

Effective Date

04/28/2000

Expiration Date

07/31/2002

City

CENTRALIA

State

Zip

62801

County

MARION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011