LEON JACOB WISE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036123706

License Status

ACTIVE

Business

First Name

LEON

Middle

JACOB

Last Name

WISE

Suffix

Business Name

LEON JACOB WISE MD

Original Issue Date

06/10/2009

Effective Date

05/18/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/18/2023