KIMBERLEE VAN WILSON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

Title

First Name

KIMBERLEE

Middle

VAN

Last Name

WILSON

Business Name

KIMBERLEE VAN WILSON DO

Original Issue Date

07/17/2014

Effective Date

07/17/2014

Expiration Date

07/31/2017

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020