BRUCE LEONARD WILSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131591

License Status

NOT RENEWED

Business

Title

First Name

BRUCE

Middle

LEONARD

Last Name

WILSON

Business Name

BRUCE LEONARD WILSON MD

Original Issue Date

10/15/2012

Effective Date

10/15/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

06/28/2016