ELIZABETH A WICKSTROM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

ELIZABETH A

Last Name

WICKSTROM

Suffix

Business Name

ELIZABETH A WICKSTROM MD

Original Issue Date

07/03/1991

Effective Date

07/03/1991

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006