ROBERT JEROME WIENECKE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

JEROME

Last Name

WIENECKE

Suffix

Business Name

ROBERT JEROME WIENECKE MD

Original Issue Date

04/12/2004

Effective Date

04/12/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006