RICHARD A WILDE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100891

License Status

NOT RENEWED

Business

First Name

RICHARD

Middle

Last Name

WILDE

Business Name

RICHARD A WILDE

Original Issue Date

08/05/1999

Effective Date

08/05/1999

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006