RICHARD A WILDE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036871

License Status

EXPIRED

Business

First Name

RICHARD

Middle

Last Name

WILDE

Business Name

RICHARD A WILDE

Original Issue Date

06/20/1997

Effective Date

06/20/1997

Expiration Date

06/15/2000

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006