JASON CRAIG WICKENS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108485

License Status

NOT RENEWED

Business

First Name

JASON

Middle

CRAIG

Last Name

WICKENS

Suffix

Business Name

JASON CRAIG WICKENS MD

Original Issue Date

01/24/2003

Effective Date

01/24/2003

Expiration Date

07/31/2005

City

ST LOUIS

State

Zip

63110

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/09/2006