DIANE B WAYNE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

First Name

DIANE

Middle

Last Name

WAYNE

Suffix

Business Name

DIANE B WAYNE MD

Original Issue Date

06/14/1994

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/14/2023