AMANDA JO DIAGUILA STEPHENS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

Title

First Name

AMANDA JO

Middle

DIAGUILA

Last Name

STEPHENS

Business Name

AMANDA JO DIAGUILA STEPHENS MD

Original Issue Date

03/03/2014

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023