JEFFREY JONATHAN WISE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

JONATHAN

Last Name

WISE

Suffix

Business Name

JEFFREY JONATHAN WISE MD

Original Issue Date

12/22/1997

Effective Date

12/22/1997

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006