MATTHEW CYRIL WENDT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

Title

First Name

MATTHEW

Middle

CYRIL

Last Name

WENDT

Business Name

MATTHEW CYRIL WENDT MD

Original Issue Date

10/08/2015

Effective Date

10/08/2015

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017