ADAM MICHAEL WISE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059806

License Status

CANCELLED

Business

Title

First Name

ADAM

Middle

MICHAEL

Last Name

WISE

Business Name

ADAM MICHAEL WISE MD

Original Issue Date

06/27/2011

Effective Date

06/27/2011

Expiration Date

06/26/2014

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

03/24/2014