BURGESS C WILSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111090

License Status

NOT RENEWED

Business

First Name

BURGESS C

Last Name

WILSON

Business Name

BURGESS C WILSON

Original Issue Date

03/25/2004

Effective Date

02/06/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021