ELIZABETH A WICKSTROM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036082667

License Status

NOT RENEWED

Business

First Name

ELIZABETH A

Last Name

WICKSTROM

Suffix

Business Name

ELIZABETH A WICKSTROM MD

Original Issue Date

06/21/1991

Effective Date

06/21/1991

Expiration Date

07/31/1993

City

PRAIRIE VILLAGE

State

Zip

66208

County

KANSAS

Ever Disciplined

LastModifiedDate

09/20/2006