DAFINA WISE ALLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

Title

First Name

DAFINA

Middle

WISE

Last Name

ALLEN

Business Name

DAFINA WISE ALLEN MD

Original Issue Date

03/21/2014

Effective Date

06/12/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017