JOHANNA LEE WICKEMEYER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071202

License Status

EXPIRED

Business

Title

First Name

JOHANNA

Middle

LEE

Last Name

WICKEMEYER

Business Name

JOHANNA LEE WICKEMEYER MD

Original Issue Date

06/24/2020

Effective Date

06/24/2020

Expiration Date

06/23/2022

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

10/11/2022