JEFFREY JONATHAN WISE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036097103

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

JONATHAN

Last Name

WISE

Suffix

Business Name

JEFFREY JONATHAN WISE MD

Original Issue Date

12/15/1997

Effective Date

12/15/1997

Expiration Date

07/31/1999

City

SOUTHFIELD

State

Zip

48076

County

MICHIGAN

Ever Disciplined

LastModifiedDate

09/20/2006