NEIL K WISE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036050195

License Status

NOT RENEWED

Business

First Name

NEIL K

Last Name

WISE

Suffix

Business Name

NEIL K WISE MD

Original Issue Date

10/10/1974

Effective Date

04/24/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

11/01/2017