CHRISTIAN WIRAWAN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

ACTIVE

Business

Title

First Name

CHRISTIAN

Last Name

WIRAWAN

Business Name

CHRISTIAN WIRAWAN DO

Original Issue Date

08/20/2024

Effective Date

08/20/2024

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/20/2024