DIANA LAURA WILSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

First Name

DIANA

Middle

LAURA

Last Name

WILSON

Suffix

Business Name

DIANA LAURA WILSON MD

Original Issue Date

12/31/1997

Effective Date

12/31/1997

Expiration Date

07/31/1999

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

09/26/2006