JOEL HENRY WIETFELDT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051621

License Status

CANCELLED

Business

Title

First Name

JOEL

Middle

HENRY

Last Name

WIETFELDT

Business Name

JOEL HENRY WIETFELDT MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

SPRINGFIELD

State

Zip

62704

Specialty/Qualifier

Plastic Surgery

Ever Disciplined

LastModifiedDate

04/09/2009