MARK E WYLAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

NOT RENEWED

Business

First Name

MARK E

Last Name

WYLAM

Suffix

Business Name

MARK E WYLAM MD

Original Issue Date

06/03/1986

Effective Date

06/03/1986

Expiration Date

07/31/1999

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006