ELLEN SWIONTKOWSKI WAGNER MD Medical Doctor License verification

Business Entity

CLOSED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071819

License Status

CLOSED

Business

Title

First Name

ELLEN

Middle

SWIONTKOWSKI

Last Name

WAGNER

Business Name

ELLEN SWIONTKOWSKI WAGNER MD

Original Issue Date

06/24/2018

Effective Date

06/24/2018

Expiration Date

06/23/2021

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/03/2018