RICKEY LEE WILSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

Title

First Name

RICKEY

Middle

LEE

Last Name

WILSON

Business Name

RICKEY LEE WILSON MD

Original Issue Date

01/11/2017

Effective Date

06/23/2020

Expiration Date

07/31/2023

City

DAVENPORT

State

Zip

52809

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023