ELISA MARIE CRYSTAL WANG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065637

License Status

CANCELLED

Business

Title

First Name

ELISA

Middle

MARIE CRYSTAL

Last Name

WANG

Business Name

ELISA MARIE CRYSTAL WANG MD

Original Issue Date

07/03/2017

Effective Date

07/03/2017

Expiration Date

07/02/2018

City

CHICAGO

State

Zip

60623

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

07/03/2017