AMANDA BLANCHE SIEGEL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

ACTIVE

Business

Title

First Name

AMANDA

Middle

BLANCHE

Last Name

SIEGEL

Business Name

AMANDA BLANCHE SIEGEL MD

Original Issue Date

07/30/2021

Effective Date

04/29/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/29/2023