KRISTIN MARIE WIESE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056429

License Status

EXPIRED

Business

Title

First Name

KRISTIN

Middle

MARIE

Last Name

WIESE

Business Name

KRISTIN MARIE WIESE MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

NAPERVILLE

State

Zip

60540

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/29/2012