HERSHEL LISTON WIX JR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

HERSHEL

Middle

LISTON

Last Name

WIX

Suffix

JR MD

Business Name

HERSHEL LISTON WIX JR MD

Original Issue Date

01/01/1997

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/27/2023