LISA S WICHTERMAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125012785

License Status

EXPIRED

Business

Title

First Name

LISA

Middle

Last Name

WICHTERMAN

Business Name

LISA S WICHTERMAN MD

Original Issue Date

06/17/1981

Effective Date

06/17/1981

Expiration Date

07/01/1983

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006