MARK RYAN WOLFE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

ACTIVE

Business

Title

First Name

MARK

Middle

RYAN

Last Name

WOLFE

Business Name

MARK RYAN WOLFE MD

Original Issue Date

01/05/2025

Effective Date

01/05/2025

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/06/2024