RUSSELL DOW DEIDIKER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139169

License Status

ACTIVE

Business

Title

First Name

RUSSELL

Middle

DOW

Last Name

DEIDIKER

Business Name

RUSSELL DOW DEIDIKER MD

Original Issue Date

09/25/2015

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

FARMINGTON

State

Zip

63640

County

MISSOURI

Ever Disciplined

LastModifiedDate

04/11/2023