DAVID B WILDE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016769

License Status

EXPIRED

Business

First Name

DAVID B

Last Name

WILDE

Suffix

Business Name

DAVID B WILDE MD

Original Issue Date

06/01/1984

Effective Date

06/01/1984

Expiration Date

06/25/1986

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006