TIMOTHY SHANE WYMAN 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

TIMOTHY

Middle

SHANE

Last Name

WYMAN

Business Name

TIMOTHY SHANE WYMAN MD

Original Issue Date

05/01/2020

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

KANKAKEE

State

Zip

60901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023