ETHAN WILSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125083306

License Status

EXPIRED

Business

Title

First Name

ETHAN

Last Name

WILSON

Business Name

ETHAN WILSON MD

Original Issue Date

06/22/2024

Effective Date

06/22/2024

Expiration Date

06/21/2025

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Transitional Year

Ever Disciplined

LastModifiedDate

11/03/2025