PRESTON JON WILSON DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056771

License Status

EXPIRED

Business

Title

First Name

PRESTON

Middle

JON

Last Name

WILSON

Business Name

PRESTON JON WILSON DO

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

08/29/2012