KRISTIN MARIE WIESE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

ACTIVE

Business

Title

First Name

KRISTIN

Middle

MARIE

Last Name

WIESE

Business Name

KRISTIN MARIE WIESE MD

Original Issue Date

05/10/2012

Effective Date

07/09/2023

Expiration Date

07/31/2026

City

NAPERVILLE

State

Zip

60540

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/09/2023