MICHELLE WIESE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125083579

License Status

ACTIVE

Business

Title

First Name

MICHELLE

Last Name

WIESE

Business Name

MICHELLE WIESE MD

Original Issue Date

07/01/2025

Effective Date

07/01/2025

Expiration Date

06/30/2027

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

02/14/2025