LEXY A WISTENBERG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

ACTIVE

Business

First Name

LEXY A

Last Name

WISTENBERG

Suffix

Business Name

LEXY A WISTENBERG MD

Original Issue Date

05/24/1991

Effective Date

05/30/2023

Expiration Date

07/31/2026

City

MORTON GROVE

State

Zip

60053

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/30/2023