JONATHAN WILLIAM HEIDT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124608

License Status

INACTIVE

Business

Title

First Name

JONATHAN

Middle

WILLIAM

Last Name

HEIDT

Business Name

JONATHAN WILLIAM HEIDT MD

Original Issue Date

11/12/2009

Effective Date

11/12/2009

Expiration Date

07/31/2011

City

SAINT LOUIS

State

Zip

63123

County

MISSOURI

Ever Disciplined

LastModifiedDate

04/07/2011