BENJAMIN W EIDEM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095302

License Status

NOT RENEWED

Business

First Name

BENJAMIN W

Last Name

EIDEM

Suffix

Business Name

BENJAMIN W EIDEM MD

Original Issue Date

04/10/1997

Effective Date

07/31/2014

Expiration Date

07/31/2017

City

ROCHESTER

State

Zip

55902

County

MINNESOTA

Ever Disciplined

LastModifiedDate

11/01/2017