DIONTE KENARD WIGGINS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

ACTIVE

Business

Title

First Name

DIONTE

Middle

KENARD

Last Name

WIGGINS

Business Name

DIONTE KENARD WIGGINS MD

Original Issue Date

06/19/2020

Effective Date

06/30/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/30/2023