GERALD A WANKUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

GERALD A

Last Name

WANKUM

Suffix

Business Name

GERALD A WANKUM MD

Original Issue Date

06/07/1990

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021