LAUREN A WIEBE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047708

License Status

CANCELLED

Business

Title

First Name

LAUREN

Middle

Last Name

WIEBE

Business Name

LAUREN A WIEBE MD

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

06/23/2007

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006