LEON JACOB WISE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

ACTIVE

Business

First Name

LEON

Middle

JACOB

Last Name

WISE

Suffix

Business Name

LEON JACOB WISE MD

Original Issue Date

06/12/2009

Effective Date

05/18/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/18/2023