AMY WAGENAAR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036164097

License Status

ACTIVE

Business

Title

First Name

AMY

Last Name

WAGENAAR

Business Name

AMY WAGENAAR MD

Original Issue Date

03/24/2023

Effective Date

07/20/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

ADAMS

Ever Disciplined

LastModifiedDate

07/20/2023