DORIS ELLEN WICKMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

First Name

DORIS ELLEN

Last Name

WICKMAN

Suffix

Business Name

DORIS ELLEN WICKMAN MD

Original Issue Date

07/19/1982

Effective Date

06/24/2008

Expiration Date

07/31/2011

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011