GEOFFREY A WISS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

GEOFFREY

Middle

Last Name

WISS

Suffix

Business Name

GEOFFREY A WISS MD

Original Issue Date

05/02/2003

Effective Date

05/02/2003

Expiration Date

07/31/2005

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006