CHARLES E WIRTZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

CHARLES E

Last Name

WIRTZ

Suffix

Business Name

CHARLES E WIRTZ MD

Original Issue Date

06/29/1989

Effective Date

06/29/1989

Expiration Date

07/31/1993

City

LENA

State

Zip

61048

County

JO DAVIESS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006