LEON JACOB WISE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050912

License Status

EXPIRED

Business

First Name

LEON

Middle

JACOB

Last Name

WISE

Suffix

Business Name

LEON JACOB WISE MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2009

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

07/15/2009