THERESE M WILSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036098380

License Status

NOT RENEWED

Business

First Name

THERESE

Middle

Last Name

WILSON

Suffix

Business Name

THERESE M WILSON MD

Original Issue Date

07/20/1998

Effective Date

07/20/1998

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

10/09/2006