MICHAEL TYLER WIISANEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053372

License Status

EXPIRED

Business

First Name

MICHAEL

Middle

TYLER

Last Name

WIISANEN

Suffix

Business Name

MICHAEL TYLER WIISANEN MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

07/08/2010