JILL M WAHL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

First Name

JILL

Middle

Last Name

WAHL

Suffix

Business Name

JILL M WAHL MD

Original Issue Date

06/24/2011

Effective Date

07/19/2017

Expiration Date

09/30/2020

City

WEST PEORIA

State

Zip

61604

County

LEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021