MATTHEW DAVID WISE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122751

License Status

NOT RENEWED

Business

Title

First Name

MATTHEW

Middle

DAVID

Last Name

WISE

Business Name

MATTHEW DAVID WISE MD

Original Issue Date

03/03/2009

Effective Date

05/19/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014