NEIL K WISE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

First Name

NEIL K

Last Name

WISE

Suffix

Business Name

NEIL K WISE MD

Original Issue Date

01/01/1997

Effective Date

04/24/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017