MICHAEL TYLER WIISANEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

TYLER

Last Name

WIISANEN

Suffix

Business Name

MICHAEL TYLER WIISANEN MD

Original Issue Date

11/06/2008

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023