NEIL W WANGSTROM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036075251

License Status

INACTIVE

Business

First Name

NEIL W

Last Name

WANGSTROM

Suffix

Business Name

NEIL W WANGSTROM MD

Original Issue Date

06/27/1987

Effective Date

06/27/1987

Expiration Date

07/31/1993

City

LAPORTE

State

Zip

46350

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006