NEIL W WANGSTROM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

First Name

NEIL W

Last Name

WANGSTROM

Suffix

Business Name

NEIL W WANGSTROM MD

Original Issue Date

08/01/1989

Effective Date

08/01/1989

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006