JACOB DOUGLAS WINGATE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125082369

License Status

ACTIVE

Business

Title

First Name

JACOB

Middle

DOUGLAS

Last Name

WINGATE

Business Name

JACOB DOUGLAS WINGATE DO

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2026

City

PEORIA

State

Zip

61605

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

03/29/2023