MARTIN NICOLAS WIJKSTROM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036120904

License Status

INACTIVE

Business

First Name

MARTIN

Middle

NICOLAS

Last Name

WIJKSTROM

Suffix

Business Name

MARTIN NICOLAS WIJKSTROM MD

Original Issue Date

05/15/2008

Effective Date

05/15/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/07/2011