JAMES R WIEFERICH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

JAMES R

Last Name

WIEFERICH

Suffix

Business Name

JAMES R WIEFERICH MD

Original Issue Date

08/15/1986

Effective Date

08/15/1986

Expiration Date

07/31/1990

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006