KETURA PREYA ANN WISNER DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058901

License Status

EXPIRED

Business

Title

First Name

KETURA

Middle

PREYA ANN

Last Name

WISNER

Business Name

KETURA PREYA ANN WISNER DO

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

03/13/2015