ELLEN SWIONTKOWSKI WAGNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

ACTIVE

Business

Title

First Name

ELLEN

Middle

SWIONTKOWSKI

Last Name

WAGNER

Business Name

ELLEN SWIONTKOWSKI WAGNER MD

Original Issue Date

06/11/2024

Effective Date

06/11/2024

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026