ANNISE GEORGETTE WILSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063652

License Status

CANCELLED

Business

Title

First Name

ANNISE

Middle

GEORGETTE

Last Name

WILSON

Business Name

ANNISE GEORGETTE WILSON MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

04/04/2016