LESLIE D WILKE DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053176

License Status

CANCELLED

Business

First Name

LESLIE

Middle

Last Name

WILKE

Suffix

Business Name

LESLIE D WILKE DO

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/18/2007