DAVID B WILDE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072806

License Status

NOT RENEWED

Business

First Name

DAVID B

Last Name

WILDE

Suffix

Business Name

DAVID B WILDE MD

Original Issue Date

06/04/1986

Effective Date

06/04/1986

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006