License Search: Details

Name	Title	Specialty	Certified	Primary Practice Location	Licensed Or Has Been Licensed In
Iwan Sugiharto Nyotowidjojo	MD	Internal Medicine	Verify Specialty Certification	Teledoc Health 1900 West Littleton Blvd. Littleton, CO (Other)	CO, MT, ID, MD, AL, NE, LA, ND, IL

License History

License Type	License Number	Status	License Date	Expiration Date
PMD	32102	Suspended by Board	01/06/2023	04/30/2025

Education History

School	Date Completed	Nature of Training
University Of Arizona College Of Medicine	05/18/2014	Medical or Podiatric School
University Of Arizona College Of Medicine	06/30/2017	Post-Graduate Training

Physician Assistant(s) Collaboration

Name
No Current Supervision

Discipline/Board Action History

Discipline/Board Action	Type of Action	Action Date	Public Documents
Yes	Suspension of License	04/30/2025	Automatic IMLC Order

Malpractice History

No Malpractice Cases On Record

This data was retrieved on 4/17/2026.