BRIAN WADE MECKLENBURG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036149788

License Status

ACTIVE

Business

Title

First Name

BRIAN

Middle

WADE

Last Name

MECKLENBURG

Business Name

BRIAN WADE MECKLENBURG MD

Original Issue Date

06/17/2019

Effective Date

07/23/2023

Expiration Date

07/31/2026

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/23/2023