License holder summary

Karl Theodore Wickstrom is a Medical - Physician licensed to practice in Colorado. The address on file for Karl Theodore Wickstrom is Medwise, 790 Gail Gardner Way, Prescott, AZ, 86305-6305. This licensed professional license is not current. The license was granted 05/05/1989 and expired on 05/31/2011.

Colorado

Division of Professions and Occupations

Karl Theodore Wickstrom
Medical - Physician
License number
29484
Date granted
05/05/1989
Date expires
05/31/2011
Class
Medical - Physician
Status
Expired
Address
Medwise, 790 Gail Gardner Way, Prescott, AZ, 86305-6305
coloradolicensing.org
ID 27453661
LAST UPDATED 2024-04-21 22:39:21 UTC

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