MEREDITH R WICKLUND MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054845

License Status

EXPIRED

Business

Title

First Name

MEREDITH

Middle

Last Name

WICKLUND

Business Name

MEREDITH R WICKLUND MD

Original Issue Date

06/02/2008

Effective Date

06/02/2008

Expiration Date

06/01/2009

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/03/2009