MCKENZIE ELLE WYLIE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072544

License Status

EXPIRED

Business

First Name

MCKENZIE

Middle

ELLE

Last Name

WYLIE

Business Name

MCKENZIE ELLE WYLIE

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/11/2022