WAYNE KENNETH MANNESS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099816

License Status

ACTIVE

Business

First Name

WAYNE

Middle

KENNETH

Last Name

MANNESS

Suffix

Business Name

WAYNE KENNETH MANNESS MD

Original Issue Date

03/10/1999

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/02/2023