CHANDLER DONOVAN WILFONG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

ACTIVE

Business

Title

First Name

CHANDLER

Middle

DONOVAN

Last Name

WILFONG

Business Name

CHANDLER DONOVAN WILFONG MD

Original Issue Date

09/18/2018

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2023