MARK E WIEST Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

WIEST

Business Name

MARK E WIEST

Original Issue Date

12/27/2006

Effective Date

12/27/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60661

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011