ADAM MICHAEL WISE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

Title

First Name

ADAM

Middle

MICHAEL

Last Name

WISE

Business Name

ADAM MICHAEL WISE MD

Original Issue Date

04/11/2014

Effective Date

04/11/2014

Expiration Date

07/31/2017

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017