HOWARD E WIARDA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030997

License Status

EXPIRED

Business

First Name

HOWARD E

Last Name

WIARDA

Business Name

HOWARD E WIARDA

Original Issue Date

05/05/1994

Effective Date

05/05/1994

Expiration Date

06/19/1997

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006