ELISA MARIE CRYSTAL WANG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

ACTIVE

Business

Title

First Name

ELISA

Middle

MARIE CRYSTAL

Last Name

WANG

Business Name

ELISA MARIE CRYSTAL WANG MD

Original Issue Date

07/26/2018

Effective Date

06/17/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60623

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/17/2023