THOMAS ALAN WISS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

First Name

THOMAS ALAN

Last Name

WISS

Suffix

Business Name

THOMAS ALAN WISS MD

Original Issue Date

09/14/1983

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011