KAITLIN ELIZABETH WANTA DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

Title

First Name

KAITLIN

Middle

ELIZABETH

Last Name

WANTA

Business Name

KAITLIN ELIZABETH WANTA DO

Original Issue Date

05/18/2016

Effective Date

05/18/2016

Expiration Date

07/31/2017

City

TINLEY PARK

State

Zip

60487

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020