DIANA GOODWINE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

Title

First Name

DIANA

Last Name

GOODWINE

Business Name

DIANA GOODWINE MD

Original Issue Date

04/12/2010

Effective Date

06/30/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60622

County

CALIFORNIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/30/2023