JACQUELINE J WISNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

JACQUELINE J

Last Name

WISNER

Suffix

Business Name

JACQUELINE J WISNER MD

Original Issue Date

10/17/1989

Effective Date

10/17/1989

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006