DARREL J WAGGONER Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036090276

License Status

ACTIVE

Business

First Name

DARREL J

Last Name

WAGGONER

Business Name

DARREL J WAGGONER

Original Issue Date

03/02/1995

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

04/07/2023