License holder summary

OTTO WILLIAM WICKSTROM, III is a Medicine - Medical Doctor licensed to practice in Michigan. This medical licensee license is not current. The license was granted 07/12/2005 and expired on 01/31/2009.

Department of Licensing and Regulatory Affairs

Board of Medicine

OTTO WILLIAM WICKSTROM, III
Medicine - Medical Doctor
License number
4301082144
Date granted
07/12/2005
Date expires
01/31/2009
Class
Medicine - Medical Doctor
Status
Lapsed
Address
michiganmedical.net
ID 38953035
LAST UPDATED 2024-01-04 17:27:20 UTC

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