ANN K BUIKEMA WIARDA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

CANCELLED

Business

First Name

ANN

Middle

Last Name

BUIKEMA WIARDA

Suffix

Business Name

ANN K BUIKEMA WIARDA MD

Original Issue Date

02/24/1999

Effective Date

02/24/1999

Expiration Date

07/31/2002

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006