ELLEN SWIONTKOWSKI WAGNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155898

License Status

ACTIVE

Business

Title

First Name

ELLEN

Middle

SWIONTKOWSKI

Last Name

WAGNER

Business Name

ELLEN SWIONTKOWSKI WAGNER MD

Original Issue Date

03/05/2021

Effective Date

05/04/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2023