NEIL W WANGSTROM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018576

License Status

EXPIRED

Business

First Name

NEIL W

Last Name

WANGSTROM

Suffix

Business Name

NEIL W WANGSTROM MD

Original Issue Date

06/13/1985

Effective Date

06/13/1985

Expiration Date

06/25/1988

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006