CHRISTOPHER LEE WISTROM DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

ACTIVE

Business

Title

First Name

CHRISTOPHER

Middle

LEE

Last Name

WISTROM

Business Name

CHRISTOPHER LEE WISTROM DO

Original Issue Date

11/08/2024

Effective Date

11/08/2024

Expiration Date

07/31/2026

City

DIXON

State

Zip

61021

County

LEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2024