MARK DAVID WIGOD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

First Name

MARK

Middle

DAVID

Last Name

WIGOD

Suffix

Business Name

MARK DAVID WIGOD MD

Original Issue Date

06/23/1998

Effective Date

06/23/1998

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