ERIC ANTHONY WIDRA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139547

License Status

NOT RENEWED

Business

Title

First Name

ERIC

Middle

ANTHONY

Last Name

WIDRA

Business Name

ERIC ANTHONY WIDRA MD

Original Issue Date

12/31/2015

Effective Date

09/07/2020

Expiration Date

07/31/2023

City

RESTON

State

Zip

20194

Ever Disciplined

LastModifiedDate

11/30/2023