LUIS A NIDEA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036073332

License Status

NOT RENEWED

Business

Title

First Name

LUIS

Middle

Last Name

NIDEA

Business Name

LUIS A NIDEA MD

Original Issue Date

07/30/1986

Effective Date

09/24/2020

Expiration Date

07/31/2023

City

GRANGER

State

Zip

46530

Ever Disciplined

LastModifiedDate

11/30/2023