RICHARD BRYAN WISE MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****66

NOT RENEWED

N

RICHARD

BRYAN

WISE

MD

RICHARD BRYAN WISE MD

05/10/2000

05/10/2000

07/31/2002

CHICAGO

IL

60614

COOK

II III IV V

N

10/09/2006