STEPHANIE DENISE WILSON 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

STEPHANIE

Middle

DENISE

Last Name

WILSON

Suffix

Business Name

STEPHANIE DENISE WILSON MD

Original Issue Date

08/25/2010

Effective Date

08/25/2010

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017