ROGER ALLEN WEISE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059446

License Status

NOT RENEWED

Business

First Name

ROGER ALLEN

Last Name

WEISE

Suffix

Business Name

ROGER ALLEN WEISE MD

Original Issue Date

09/18/1979

Effective Date

04/25/2017

Expiration Date

09/30/2020

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

01/14/2021