BURGESS C WILSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041303

License Status

EXPIRED

Business

First Name

BURGESS C

Last Name

WILSON

Business Name

BURGESS C WILSON

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006